Healthcare Provider Details

I. General information

NPI: 1275569493
Provider Name (Legal Business Name): ZEENAT SIDDIQUI SAJJAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 B QUINCE ORCHARD BLVD
GAITHERSBURG MD
20878
US

IV. Provider business mailing address

807 QUINCE ORCHARD BLVD 22
GAITHERSBURG MD
20878
US

V. Phone/Fax

Practice location:
  • Phone: 301-977-2440
  • Fax: 301-977-4752
Mailing address:
  • Phone: 301-926-6492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0045159
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: