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General NPI Number Information
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NPI Number | 1235380593
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Entity Type | Individual
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Provider Name | AFSHEEN SIDDIQUE M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 6600 VAN AALST BLVD BLDG 9250
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City | FORT MOORE
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State | GA
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Zip | 31905-2102
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Country | US
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Telephone | 762-408-0374
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 MANCHESTER EXPY STE 2001A
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City | COLUMBUS
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State | GA
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Zip | 31904-6802
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Country | US
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Telephone | 706-320-3126
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Fax | 706-320-3054
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 20414
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 34287
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 80234
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License Number State | ZZ
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