MOHAMMED ABDUL KHADAR SIDDIQUI (NPI# 1508228669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508228669 |
| Entity Type | Individual |
| Full Name | MOHAMMED ABDUL KHADAR SIDDIQUI |
| Credential | DO |
| Practice Address |
1802 Braeburn Dr Salem VA 24153-7357 |
| Mailing Address |
2000 Health Park Dr Fl Hp2 Brentwood TN 37027-4525 |
| Practice Telephone | 5407723580 |
| Practice Fax Number | 5407255012 |
| Mailing Telephone | 6153737600 |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2020-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 0102205592 | VA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1465 S Grand Blvd Rm 2712, Saint Louis, MO 631041003 | 3145775634 | 3145775616 |
| 1802 Braeburn Dr, Salem, VA 241537357 | 5407723580 | 5407255012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184916983 | Mohammed Muhibbulla Siddiqui | Internal Medicine | 451 E Almond Ave Ste 101, Madera, CA 93637-5562 | 2011-05-11 |
| 1962598086 | Mohammed Abdul Raoof Siddiqui | Internal Medicine | 13 W Us Highway 30, Schererville, IN 46375-2266 | 2006-10-05 |
| 1417584707 | Mohammed Zaid Siddiqui | Student in an Organized Health Care Education/Training Program | 4440 W 95th St Rm 131, Oak Lawn, IL 60453-2600 | 2020-03-25 |
| 1861056251 | Mohammed Siddiqui | Student in an Organized Health Care Education/Training Program | 600 S Paulina St Ste 403, Chicago, IL 60612-3806 | 2019-05-01 |
| 1215432596 | Mohammed Abdulqawi Siddiqui | Student in an Organized Health Care Education/Training Program | 1801 N Broad St, Philadelphia, PA 19122-6003 | 2018-03-28 |
| 1215303375 | Mohammed Azfar Siddiqui | Radiology | One Hospital Dr, Columbia, MO 65212-0001 | 2015-08-12 |
| 1275917957 | Mohammed Siddiqui | Internal Medicine | 1 Hurley Plz, Flint, MI 48503-5902 | 2015-07-13 |
| 1134538317 | Mohammed Siddiqui | Pharmacist | 360 Hungerford Dr, Rockville, MD 20850-4167 | 2014-08-12 |
| 1255746632 | Mohammed Siddiqui | Internal Medicine | 230 N Broad St, Philadelphia, PA 19102-1121 | 2014-06-24 |
| 1902246325 | Mohammed A Siddiqui | Student in an Organized Health Care Education/Training Program | 4422 3rd Ave, Bronx, NY 10457-2545 | 2013-06-29 |
| Street Address |
1802 BRAEBURN DR |
| City | SALEM |
| State | VA |
| Zip Code | 24153-7357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134121338 | Mark R Hanabury Jr. | Specialist | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2005-06-01 |
| 1841851433 | Grace Julia Valiulis | Physician Assistant | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2019-06-24 |
| 1083279376 | Olivia Jayne Darwin | Physician Assistant | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2019-05-02 |
| 1487166088 | Christopher Cutchin Coulter | Nurse Practitioner | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2017-11-04 |
| 1063946358 | Kimberly Charise Martin | Nurse Practitioner | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2017-04-13 |
| 1699215434 | Shannon Michelle Snyder | Physician Assistant | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2017-02-27 |
| 1255875589 | Sarah Markwood | Nurse Practitioner | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2016-12-06 |
| 1437506789 | Nicole Crowder | Registered Nurse | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2016-05-17 |
| 1851757629 | Alisha O Lipes | Physician Assistant | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2016-01-11 |
| 1043685399 | Megan Smith | Nurse Practitioner | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2015-12-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669001228 | Paul Mcguire | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Drive Psychiatry Gme, Salem, VA 24153 | 2020-04-06 |
| 1386114965 | Dynamic Medical LLC | Clinical Medical Laboratory | 1201 Texas Street, Salem, VA 24153 | 2018-11-27 |
| 1134607898 | Renew Psychiatry Services | Psychiatry & Neurology | 177 Electric Rd, Salem, VA 24153 | 2018-08-03 |
| 1508304015 | Samantha Getz | Assisted Living Facility | 3706 Knollridge Rd., Salem, VA 24153 | 2017-02-03 |
| 1518409762 | Melissa Ward | Case Manager/Care Coordinator | 1380 Southside Dr, Suite 100, Salem, VA 24153 | 2016-11-04 |
| 1154729051 | Allison Marie Parry | Physician Assistant | 1336 W Main St., Salem, VA 24153 | 2014-12-09 |
| 1598199457 | Stacy Stanley | Occupational Therapy Assistant | 4812 Moore Rd, Salem, VA 24153 | 2013-08-28 |
| 1366888034 | Dolores Hager | Speech-Language Pathologist | 1851 Harrogate Dr, Salem, VA 24153 | 2013-05-21 |
| 1073850764 | Joel Aaron Nickerson | Specialist/Technologist | 400 Spartan Dr., Salem High School, Salem, VA 24153 | 2013-01-15 |
| 1023387271 | National Diabetic Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 2153 Apperson Drive, Salem, VA 24153 | 2011-12-16 |
| Find all providers in zip 24153 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730440058 | Matthew Hatler | Pediatrics | 2478 13th St. Se, Salem, OR 97302-2546 | 2012-06-04 |
| 1033409016 | William Christopher Thomsen Jr. | Pediatrics | 1641 Millwood Dr, Salem, VA 24153-4616 | 2011-04-12 |
| 1275708539 | Children's Medical Group | Pediatrics | 24906 75th St, Salem, WI 53168-9705 | 2008-04-28 |
| 1346378213 | Cooper Pediatrics | Pediatrics | 330 Woodstown Road., Medical Arts Bldg 7, Salem, NJ 08079 | 2007-03-01 |
| 1053424291 | Linda J Morgan | Pediatrics | 57 Highlands Ave, Er, Salem, MA 01970 | 2006-08-15 |
| 1700813854 | Dorin Meredith Kemmerle | Pediatrics | 4350 Commercial St Se, Salem, OR 97302-3914 | 2006-06-26 |
| 1043252612 | Kimberly Ann Heggen | Pediatrics | 891 23rd St Ne, Salem, OR 97301-1793 | 2006-06-11 |
| 1770525263 | Fara Katrina Etzel | Pediatrics | 2395 Center St Ne, Salem, OR 97301-4464 | 2006-06-11 |
| 1083675953 | Donald T Mcauliffe | Pediatrics | 72 Highland Avenue, Pediatric Associates of Greater Salem, Salem, MA 01970 | 2006-03-30 |
| 1336116474 | Madeleine Ana Ortiz | Pediatrics | 1076 E State St, Salem, OH 44460-2228 | 2006-03-08 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.