Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35-027607 | OH |
N | 111NI0900X | Internist | 35-027607 | OH |
Y | 207RH0000X | Hematologist | 35-027607 | OH |
NPI | 1215995600 |
---|---|
Provider Name | Carl William Siegrist |
First Address | Cincinnati, OH 45226-2326 |
Second Address | Cincinnati, OH 45219-2103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 28/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0169017 | (05) | OH |
100390190 | (05) | IN |
64782436 | (05) | KY |
830007660 | RAILROAD MEDICARE (01) | OH |
A73550 | (02) |