Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 45989 | AZ |
N | 111NI0900X | Internist | 45989 | AZ |
Y | 208000000X | Pediatrician | MD041306 | DC |
N | 2080P0208X | Pediatric Infectious Diseases | MD041306 | DC |
NPI | 1093976516 |
---|---|
Provider Name | Dr. Melissa Siedschlag |
First Address | Reston, VA 20191-1555 |
Second Address | Washington, DC 20010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2008 |
Last Update Date | 04/07/2018 |