MEDICARE: FAIZAH SIDDIQI MIAH DO

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	207L00000X	Anesthesiology Physician	13867	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13867	OTHER	GA	MEDICAL LICENSE NUMBER

General Provider Information

NPI Number	:	1811626781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAIZAH SIDDIQI MIAH DO

Provider Business Mailing Address
First Line	:	107 BLUE RIDGE TRL
Second Line	:
City	:	MOORESVILLE
State	:	NC
Zip	:	28117-8477
Country	:	US
Telephone Number	:	252-327-6755
Fax Number	:

Provider Business Practice Location Address
First Line	:	169 ASHLEY AVE RM 202
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8905
Country	:	US
Telephone Number	:	843-792-2322
Fax Number	:

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

Provider Enumeration Date	:	06/07/2022
Last Update Date	:	06/02/2026

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Directions to “ FAIZAH SIDDIQI MIAH DO” Practice Location

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