MEDICARE: DR. NASEEMUL H SIDDIQI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD10343	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104823079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NASEEMUL H SIDDIQI M.D.

Provider Business Mailing Address
First Line	:	2001 LAUREL AVE
Second Line	:	SUITE 202
City	:	KNOXVILLE
State	:	TN
Zip	:	37916-1810
Country	:	US
Telephone Number	:	865-637-5186
Fax Number	:	865-637-8487

Provider Business Practice Location Address
First Line	:	2001 LAUREL AVE
Second Line	:	SUITE 202
City	:	KNOXVILLE
State	:	TN
Zip	:	37916-1810
Country	:	US
Telephone Number	:	865-637-5186
Fax Number	:	865-637-8487

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2005
Last Update Date	:	09/16/2015

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