| Siraj A Siddiqui, Md | |
|
216 W Main St Crestline OH 44827-1431 | |
| (419) 683-8041 | |
| Not Available |
| Full Name | Siraj A Siddiqui, Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 216 W Main St, Crestline, Ohio |
| Authorized Official Name and Position | Siraj A Siddiqui (OWNER) |
| Authorized Official Contact | 4197749993 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Siraj A Siddiqui, Md 1613 Hidden Oak Trl Mansfield OH 44906-3558 Ph: (419) 774-9993 | Siraj A Siddiqui, Md 216 W Main St Crestline OH 44827-1431 Ph: (419) 683-8041 |
| NPI Number | 1144409673 |
|---|---|
| Provider Enumeration Date | 11/01/2007 |
| Last Update Date | 11/01/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144409673 | NPI | - | NPPES |
| 000000140397 | Other | OH | ANTHEM |
| 0954347 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35065056S (Ohio) | Primary |
Gch Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 N Seltzer St, Crestline, OH 44827 Phone: 419-683-3200 | |
Gch Physician Practices, Seltzer Station Campus Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 385 N. Seltzer Street, Crestline, OH 44827 Phone: 419-468-4841 Fax: 419-468-2381 | |
Gch Physician Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 330 N Seltzer St, Crestline, OH 44827 Phone: 419-468-4841 |