Healthcare Provider Details

I. General information

NPI: 1972539583
Provider Name (Legal Business Name): RASHEED A SIDDIQUI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 ABBEY RD STE A
CHARLOTTESVILLE VA
22911-3553
US

IV. Provider business mailing address

PO BOX 8310
ROANOKE VA
24014-0310
US

V. Phone/Fax

Practice location:
  • Phone: 434-295-3600
  • Fax: 434-220-0121
Mailing address:
  • Phone: 540-345-3556
  • Fax: 540-777-1147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number101055367
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: