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General NPI Number Information
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NPI Number | 1528368701
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Entity Type | Organization
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Legal Business Name | MUHAMMAD ALI SIDDIQUI, MD PA
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Dates
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Enumeration Date | 10/22/2010
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 4701 FAIRWAY AVE SUITE D
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City | N LITTLE ROCK
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State | AR
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Zip | 72116-8066
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Country | US
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Telephone | 501-975-3616
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Fax | 501-975-6705
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Provider Business Mailing Address
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Address Line | 4701 FAIRWAY AVE SUITE 201
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City | N LITTLE ROCK
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State | AR
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Zip | 72116-8066
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Country | US
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Telephone | 501-975-3616
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Fax | 501-975-6705
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. MUHAMMAD ALI SIDDIQUI MD
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Credential | MD
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Telephone | 501-975-3616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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