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General NPI Number Information
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NPI Number | 1730130063
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Entity Type | Organization
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Legal Business Name | MACOMB INTERNISTS PC
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 46857 GARFIELD RD
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City | MACOMB
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State | MI
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Zip | 48044-5225
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Country | US
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Telephone | 586-532-8500
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Fax | 586-532-1515
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Provider Business Mailing Address
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Address Line | 46857 GARFIELD RD
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City | MACOMB
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State | MI
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Zip | 48044-5225
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Country | US
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Telephone | 586-532-8500
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Fax | 586-532-1515
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMED S SIDDIQUE
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Credential | MD
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Telephone | 586-532-8500
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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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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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