Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | ME 53723 | FL |
NPI | 1033106752 |
---|---|
Provider Name | Dr. Steven Siegel |
First Address | Jacksonville, FL 32256 |
Second Address | Jacksonville, FL 32204-4732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 07/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000324992E | (05) | GA |
062186200 | (05) | FL |
07396 | BCBS (01) | FL |
204499 | AVMED (01) | FL |
4288449 | AETNA (01) | FL |
D41857 | (02) | FL |