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250 Fame Avenue Suite 203 Hanover PA 17331 | |
(717) 637-2100 | |
(717) 637-2301 |
Full Name | |
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Speciality | Internal Medicine |
Location | 250 Fame Avenue, Hanover, Pennsylvania |
Authorized Official Name and Position | Khalid Aquil Siddiqui (PRESIDENT) |
Authorized Official Contact | 7176372100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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250 Fame Avenue Suite 230 Hanover PA 17331 Ph: (717) 637-2100 | 250 Fame Avenue Suite 203 Hanover PA 17331 Ph: (717) 637-2100 |
NPI Number | 1326151200 |
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Provider Enumeration Date | 08/16/2006 |
Last Update Date | 02/17/2011 |
Medicare PECOS PAC ID | 3971681727 |
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Medicare Enrollment ID | O20080421000220 |
Identifier | Type | State | Issuer |
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1326151200 | NPI | - | NPPES |
01564529 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | MD 052832 L (Pennsylvania) | Primary |
Provider Name | Khalid A Siddiqui |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1295848182 PECOS PAC ID: 2860579869 Enrollment ID: I20080401000530 |
Michael L. Peck, D.o., Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3130 Grandview Rd, Hanover, PA 17331 Phone: 717-637-0839 Fax: 717-637-9314 | |
Quad/med, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 240 Kindig Lane, Plant 5, Hanover, PA 17331 Phone: 414-566-4000 | |