Organization
ALLEGENY MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHAB Z. SIDDIQUI MD (MD/OWNER)
(301) 791-2510
Entity
Organization
Contact information
Practice address
324 EAST ANTIETAM STR., SUITE 305, HAGERSTOWN, MD 21740-5768
(301) 791-2510
(301) 739-7798
Mailing address
324 EAST ANTIETAM ST., SUITE 305, HAGERSTOWN, MD 21740-5768
(301) 791-2510
(301) 739-7798
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
D0072433
MD
282E00000X
Long Term Care Hospital
D0072433
MD
282NR1301X
Rural Acute Care Hospital
D0072433
MD
Other
Enumeration date
09/19/2011
Last updated
06/25/2013
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