Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | 35-069270 | OH |
Y | 207RI0200X | Infectious Disease | MD60266117 | WA |
NPI | 1073552709 |
---|---|
Provider Name | Abdul R Siddiqui |
First Address | Auburn, WA 98001-4939 |
Second Address | Auburn, WA 98001-4939 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 27/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2673067 | (05) | OH |
G29267 | (02) |