Provider Demographics
NPI:1447881479
Name:SIDDIQI, WAJEEHA (RPH)
Entity type:Individual
Prefix:MRS
First Name:WAJEEHA
Middle Name:
Last Name:SIDDIQI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 N WAYNE RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-2713
Mailing Address - Country:US
Mailing Address - Phone:734-729-9210
Mailing Address - Fax:
Practice Address - Street 1:6501 N WAYNE RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-2713
Practice Address - Country:US
Practice Address - Phone:734-729-9210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035006183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist