Organization
SHOALS MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD SIDDIQUE M.D. (DIRECTOR)
(256) 320-5405
Entity
Organization
Contact information
Practice address
1120 S JACKSON HWY, SUITE 301-B, SHEFFIELD, AL 35660-5777
(256) 320-5405
(256) 320-5407
Mailing address
1120 S JACKSON HWY, SUITE 301-B, SHEFFIELD, AL 35660-5777
(256) 320-5405
(256) 320-5407
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
22371
AL
Other
Enumeration date
12/10/2008
Last updated
04/23/2010
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