Healthcare Provider Details

I. General information

NPI: 1043508450
Provider Name (Legal Business Name): SAIQA SHABBIR CHOUDHRY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2011
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HIGH ST
LEWISTON ME
04240-7653
US

IV. Provider business mailing address

10 HIGH ST
LEWISTON ME
04240-7653
US

V. Phone/Fax

Practice location:
  • Phone: 207-576-1359
  • Fax:
Mailing address:
  • Phone: 207-576-1359
  • Fax: 207-570-9743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberD80898
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: