Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 0101233983 | VA |
Y | 111NI0900X | Internist | 0101233983 | VA |
N | 207RG0300X | Geriatric Medicine | 45507 | TN |
NPI | 1093770224 |
---|---|
Provider Name | Haya Waseem Siddiqi |
First Address | Richmond, VA 23228-6014 |
Second Address | Richmond, VA 23228-6014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 12/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093770224 | (05) | VA |