MEDICARE: DR. SABIHA T SIDDIQUI 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	207Q00000X	Family Medicine Physician	2019036727	MO

General Provider Information

NPI Number	:	1386669760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SABIHA T SIDDIQUI M.D.

Provider Business Mailing Address
First Line	:	# L3571
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43260-0001
Country	:	US
Telephone Number	:	937-885-3206
Fax Number	:

Provider Business Practice Location Address
First Line	:	224 S WOODS MILL RD STE 570
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-3513
Country	:	US
Telephone Number	:	314-205-6898
Fax Number	:	314-590-5911

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	09/03/2020

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