Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 4301097725 | MI |
N | 208600000X | Surgeon | 4301097725 | MI |
N | 2086S0102X | Surgical Critical Care | 2014-00001 | NC |
N | 2086S0102X | Surgical Critical Care | 4301097725 | MI |
N | 2086S0120X | Pediatric Surgery | 66178 | WI |
Y | 2086S0120X | Pediatric Surgery | E-14223 | AR |
NPI | 1275798712 |
---|---|
Provider Name | Sabina M Siddiqui |
First Address | Little Rock, AR 72225-1418 |
Second Address | Springdale, AR 72762-0845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2008 |
Last Update Date | 17/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1275798712 | (05) | WI |