Healthcare Provider Details

I. General information

NPI: 1174086896
Provider Name (Legal Business Name): MOHAMMAD-SAAD MUSTAFA SIDDIQUI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE
CINCINNATI OH
45219-2989
US

IV. Provider business mailing address

927 PARADROME ST APT 1
CINCINNATI OH
45202-5514
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35.149189
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: