Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 0101233817 | VA |
NPI | 1013928142 |
---|---|
Provider Name | Dr. Talha Siddiqui |
First Address | Alexandria, VA 22310-2540 |
Second Address | Alexandria, VA 22310-2540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 05/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013928142 | (05) | VA |
1548443153 | (05) | VA |
G62216 | (02) | VA |