Healthcare Provider Details

I. General information

NPI: 1245818749
Provider Name (Legal Business Name): DR. ALI AHMAD SIDDIQUI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982315 NEBRASKA MEDICAL CTR # NE
OMAHA NE
68198-2315
US

IV. Provider business mailing address

982315 NEBRASKA MEDICAL CTR # NE
OMAHA NE
68198-2315
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-7300
  • Fax: 402-559-8985
Mailing address:
  • Phone: 402-559-7300
  • Fax: 402-559-8985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number37362
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: