Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Siraj U Siddiqi, MD

Individual provider Internal Medicine Physician · NPI 1912056318

Siraj U Siddiqi, MD is an Internal Medicine in Carrollton, Kentucky. Graduated from Jc Edwards School of Medicine, Marshall University in 1990, 36 years ago. Practices with Proactive Therapy, Inc, a 122-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
36
Trained at
Jc Edwards School of Medicine, Marshall University
Licensed in
KY
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

309 11th St
Carrollton, KY 41008-1435
Phone: (502) 732-3280
Fax: (502) 575-6234
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1019 Commerce Pkwy, La Grange, KY 40031-8779 — (502) 225-9098

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 28062 (KY)

Record details

NPI number1912056318
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 9, 2007
Last updated in NPPESJune 15, 2026
Certification dateJune 15, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolJC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
Graduated 1990 (36 years in practice)
Group practice Proactive Therapy, Inc — 122 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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