| Allegeny Medical Llc | |
|
324 East Antietam Str. Suite 305 Hagerstown MD 21740-5768 | |
| (301) 791-2510 | |
| (301) 739-7798 |
| Full Name | Allegeny Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 324 East Antietam Str., Hagerstown, Maryland |
| Authorized Official Name and Position | Shahab Z. Siddiqui (MD/OWNER) |
| Authorized Official Contact | 3017912510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Allegeny Medical Llc 324 East Antietam St. Suite 305 Hagerstown MD 21740-5768 Ph: (301) 791-2510 | Allegeny Medical Llc 324 East Antietam Str. Suite 305 Hagerstown MD 21740-5768 Ph: (301) 791-2510 |
| NPI Number | 1821370644 |
|---|---|
| Provider Enumeration Date | 09/19/2011 |
| Last Update Date | 06/25/2013 |
| Medicare PECOS PAC ID | 2860631959 |
|---|---|
| Medicare Enrollment ID | O20130621000097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821370644 | NPI | - | NPPES |
| Provider Name | Shahab Z Siddiqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962448902 PECOS PAC ID: 9537228770 Enrollment ID: I20081107000485 |
| Provider Name | Noor Siddiqui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104098540 PECOS PAC ID: 8729253349 Enrollment ID: I20111209000599 |
| Provider Name | Guiselly Erazo-romero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528551223 PECOS PAC ID: 2365794088 Enrollment ID: I20181008003392 |
| Provider Name | Cristina Butler-lugo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033865266 PECOS PAC ID: 4789061540 Enrollment ID: I20220517000335 |
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