Nadeem A Siddiqui, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

017497 Issued in ME

Practice address

200 Kennedy Memorial Dr
Waterville, ME 04901-4526

Phone

(207) 861-3000

Fax

(207) 861-3025

NPI assigned

Feb 15, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1104094879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014526",
            "telephone_number": "207-861-3000",
            "fax_number": "207-861-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014526",
            "telephone_number": "207-861-3000",
            "fax_number": "207-861-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "NADEEM",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "017497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "017497",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Waterville, ME
• Providers in Waterville, ME by specialty
• Internal Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.