Provider Demographics
NPI:1578319570
Name:SIDDIQUA, ASFIA (MD)
Entity type:Individual
Prefix:
First Name:ASFIA
Middle Name:
Last Name:SIDDIQUA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 W 40TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-6069
Mailing Address - Country:US
Mailing Address - Phone:870-541-6000
Mailing Address - Fax:870-541-6009
Practice Address - Street 1:1993 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7309
Practice Address - Country:US
Practice Address - Phone:870-793-2540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program