Healthcare Provider Details

I. General information

NPI: 1740621739
Provider Name (Legal Business Name): UZMA MOHAMMAD SIDDIQUI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2013
Last Update Date: 07/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HITCHCOCK WAY ENDOCRINOLOGY
MANCHESTER NH
03104-0002
US

IV. Provider business mailing address

100 HITCHCOCK WAY ENDOCRINOLOGY
MANCHESTER NH
03104-0002
US

V. Phone/Fax

Practice location:
  • Phone: 603-645-6401
  • Fax:
Mailing address:
  • Phone: 603-645-6401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number18537
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number256379
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: