Individual
SHAHAB Z SIDDIQUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
324 E ANTIETAM ST STE 305, HAGERSTOWN, MD 21740-5768
(301) 791-2510
(301) 739-7798
Mailing address
324 E ANTIETAM ST STE 305, HAGERSTOWN, MD 21740-5768
(301) 791-2510
(301) 739-7798
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
D45031
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044221600
—
MD
Enumeration date
06/20/2006
Last updated
10/04/2012
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