Individual
ABDULBAGE EL SIDDIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 WILLOW CREEK RD STE F, PRESCOTT, AZ 86301-1645
(928) 227-0912
Mailing address
1222 E MALCOLM X ST, LANSING, MI 48912-1618
(517) 505-5162
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
R81022
AZ
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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