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General NPI Number Information
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NPI Number | 1922024751
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Entity Type | Individual
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Provider Name | MOHAMMAD RASHID SIDDIQUI MD
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 27931 C DR N
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City | ALBION
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State | MI
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Zip | 49224-8402
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Country | US
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Telephone | 517-629-8416
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Fax | 517-629-6640
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Provider Business Mailing Address
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Address Line | PO BOX 67000 DEPARTMENT 272801
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City | DETROIT
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State | MI
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Zip | 48267-2728
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Country | US
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Telephone | 517-629-8416
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Fax | 517-629-6640
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | MS033848
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301033848
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License Number State | MI
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