Individual
SARTAJ KADIWALA SIDDIQUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
101 MEDICAL DR, VICTORIA, TX 77904-3102
(856) 782-2212
(856) 782-2266
Mailing address
1000 HADDONFIELD BERLIN RD STE 210, VOORHEES, NJ 08043-3520
(856) 782-2212
(856) 782-2266
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
OS11312
FL
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
P7475
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003110020A
—
GA
05
—
003652900
—
FL
01
—
14E5Q
BCBSFL
FL
05
—
3664609
—
TX
Enumeration date
05/30/2008
Last updated
10/21/2021
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