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Provider Information for 1114935178

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. MICHAEL G SIEGMAN MD

Gender: MALE

Individual NPI: 1114935178

Calendar   Last Updated:  2020-07-02
  Certification Date:  2020-07-02

Details

Name Value
NPI 1114935178
Enumeration Date 2006-08-04
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 519 MEDICAL OAKS AVE
BRANDON, FL 33511
United States

Phone: 813-685-7995 | Fax: 813-685-8802
View Map External Link
Primary Practice Address 519 MEDICAL OAKS AVE
BRANDON, FL 33511
United States

Phone: 813-685-7995 | Fax: 813-685-8802
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID FL 266659600
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 208600000X - Surgery FL ME72639
No 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) FL ME72639