Organization
LAFAYETTE PAIN CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAZIA M SIDDIQUI MD (OWNER)
(765) 714-4344
Entity
Organization
Contact information
Practice address
1101 MICHIGAN AVE STE 30, LOGANSPORT, IN 46947-1528
(574) 753-7541
(574) 725-3593
Mailing address
770 PARK EAST BLVD, SUITE B, LAFAYETTE, IN 47905-0786
(765) 714-4344
(765) 838-3200
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
IN
Other
Enumeration date
05/19/2017
Last updated
06/08/2017
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