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General NPI Number Information
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NPI Number | 1811916760
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Entity Type | Individual
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Provider Name | MEERA B SIDDHARTH M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 39TH & CHESTNUT STREET SUITE 110
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4399
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Country | US
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Telephone | 215-590-5090
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Fax | 215-590-5048
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Provider Business Mailing Address
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Address Line | 39TH & CHESTNUT STREET SUITE 110
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4399
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Country | US
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Telephone | 215-590-5090
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Fax | 215-590-5048
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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 | MD417714
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | MD417714
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License Number State | PA
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