Individual
OMER ASIF SIDDIQUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 EASTMORELAND AVE STE 445, MEMPHIS, TN 38104-7536
(901) 866-8810
(901) 302-2450
Mailing address
1068 CRESTHAVEN RD STE 300, MEMPHIS, TN 38119-0809
(901) 866-8748
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23721
MS
207R00000X
Internal Medicine Physician
46512
TN
207R00000X
Internal Medicine Physician
E6551
AR
207RN0300X
Nephrology Physician
Primary
46512
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03001574
—
MS
05
—
1524078
—
TN
05
—
187456001
—
AR
Enumeration date
06/21/2007
Last updated
07/09/2025
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