Individual
KHURRAM S SIDDIQUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 N CAPITOL AVE, NP E-140, INDIANAPOLIS, IN 46202-1218
(317) 962-2894
(317) 963-5285
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01054953A
IN
208M00000X
Hospitalist Physician
01054953A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200387890
—
IN
Enumeration date
05/05/2006
Last updated
07/15/2025
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