1437110053 NPI number — DR. SALMAN SIDDIQUI M.D.

Table of content: DR. SALMAN SIDDIQUI M.D. (NPI 1437110053)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437110053 NPI number — DR. SALMAN SIDDIQUI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIDDIQUI
Provider First Name:
SALMAN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437110053
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
269 MEDICAL PARK BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PETERSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23805-9337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-861-0700
Provider Business Mailing Address Fax Number:
804-863-4626

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
207 N 4TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOPEWELL
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23860-2503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-541-0918
Provider Business Practice Location Address Fax Number:
804-541-7924
Provider Enumeration Date:
03/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0804X , with the licence number:  0101227643 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P0800X , with the licence number: 0101227643 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2042750 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 258008 . This is a "HEALTHKEEPERS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: P00208843 . This is a "RR MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 258007 . This is a "HEALTHKEEPERS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 270038 . This is a "TRICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 258007 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 004945115 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 153652 . This is a "VALUE OPTIONS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 286973 . This is a "ANTHEM BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: O83614 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 258008 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7087304 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: O083614 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 007114729 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: O83614 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 258008 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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