Organization
LAFAYETTE PAIN CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAZIA MERAJ SIDDIQUI MD (OWNER / MD)
(765) 714-4344
Entity
Organization
Contact information
Practice address
107 S WASHINGTON ST STE C, KOKOMO, IN 46901
(765) 450-6735
(765) 838-3200
Mailing address
770 PARK EAST BLVD STE B, LAFAYETTE, IN 47905-0786
(573) 468-6501
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/05/2014
Last updated
07/11/2018
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