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General NPI Number Information
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NPI Number | 1225351430
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Entity Type | Organization
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Legal Business Name | SABA SIDDIQI MD PA
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 03/03/2010
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Provider Practice Location Address
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Address Line | 9106 PHILADELPHIA RD SUITE 204
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City | BALTIMORE
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State | MD
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Zip | 21237-4329
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Country | US
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Telephone | 410-687-8777
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Fax | 410-687-1756
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Provider Business Mailing Address
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Address Line | PO BOX 426
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City | RIDERWOOD
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State | MD
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Zip | 21139-0426
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Country | US
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Telephone | 410-687-8777
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Fax | 410-687-1756
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SABA SIDDIQI
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Credential | MD
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Telephone | 410-687-8777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | D0041496
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License Number State | MD
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