Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 0101237932 | VA |
NPI | 1265483820 |
---|---|
Provider Name | Dr. Faisal A Siddiqui |
First Address | Manassas, VA 20108-4600 |
Second Address | Manassas, VA 20110-3647 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 24/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I06023 | (02) |