Individual
ALI H SIDDIQUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4805 S MOORLAND RD, MOORLAND RESERVE, NEW BERLIN, WI 53151-7401
(262) 798-7200
(262) 798-7201
Mailing address
4805 S MOORLAND RD, MOORLAND RESERVE, NEW BERLIN, WI 53151-7401
(262) 798-7200
(262) 798-7201
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
336082767
IL
207Q00000X
Family Medicine Physician
Primary
65022
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361214262
—
IL
01
—
P00968583
RRMCARE THRU CES
IL
Enumeration date
05/03/2007
Last updated
02/01/2016
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