Individual
MOHAMMAD SIDIQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1039 HASKINS RD, BOWLING GREEN, OH 43402-9065
(419) 352-1121
(419) 352-1179
Mailing address
745 HASKINS RD, SUITE B, BOWLING GREEN, OH 43402-1637
(419) 353-7069
(419) 353-7076
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35034291S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0183626
—
OH
01
—
DA5101
RR MEDICARE
OH
Enumeration date
06/09/2005
Last updated
09/02/2010
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