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General NPI Number Information
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NPI Number | 1720345929
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Entity Type | Individual
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Provider Name | ADEEL MOHAMMAD SIDDIQUI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 350 W COLUMBIA ST STE 310
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City | EVANSVILLE
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State | IN
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Zip | 47710-1782
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Country | US
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Telephone | 812-450-8600
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Fax | 812-450-8151
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Provider Business Mailing Address
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Address Line | PO BOX 1230
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City | EVANSVILLE
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State | IN
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Zip | 47706-1230
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Country | US
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Telephone | 812-450-6815
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Fax | 812-450-6822
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2015-01561
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2015-01561
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 01083420A
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License Number State | IN
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