Mohammad Rashid Siddiqui, MD
Individual provider Active NPI Family Medicine Physician · Albion, MI
NPI 1922024751 · NPPES record last updated Jan 12, 2012
Key facts
- NPI
- 1922024751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4301033848 (MI)
- Practice address
- 27931 C Dr N
Albion, MI 49224-8402 - Phone
- (517) 629-8416
- Fax
- (517) 629-6640
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071228000306 | MI | Practitioner - Family Practice | 2567542848 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301033848 | MI | MD | Family Medicine Physician |
| MS033848 | MI | MD | Geriatric Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W.a. Foote Memorial Hospital, Inc | Current |
Accepting new patients | |
| Wa Foote Memorial Hospital, Inc | Family Medicine | Current |
Accepting new patients |
| Henry Ford Pathology | Current | Accepting new patients | |
| W. a. Foote Memorial Hospital, Inc | Current | Accepting new patients | |
| Ella E M Brown Charitable Circle | Past | Accepting new patients |
Locations
27931 C Dr N
Albion, MI 49224
Phone (517) 629-8311
205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730
130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500
Interoperability endpoints
- msiddiqui452755@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | MS033848 | MI | |
| Family Medicine Physician | 207Q00000X | 4301033848 | MI | Yes |
Addresses
Primary practice location
27931 C Dr N
Albion, MI 49224-8402
Mailing address
PO Box 67000
Department 272801
Detroit, MI 48267-2728
Phone (517) 629-8416
Other providers in Albion, MI
- Tamara Rouse
- Regina Roza
- S P G B Services
- Schaff Vision Care, LLC
- Sequel Youth Services of Albion, LLC
- Ska at Home Visiting Doctor PC
- Beranda J Sloan
- Joshua Smith
- South Central Michigan Substance Abuse Commission Minority Program Ser
- Stahl Family Dentistry PLLC
All providers in Albion, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.