Individual
WAJID ALI SIDDIQUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1333 TAYLOR ST, SUITE 6-F, COLUMBIA, SC 29201-2923
(803) 296-3273
(803) 296-7061
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7303
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT186425
PA
207RI0200X
Infectious Disease Physician
Primary
34048
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340483
—
SC
Enumeration date
04/29/2008
Last updated
09/10/2020
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