Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 5101023759 | MI |
N | 207V00000X | Obstetrician & Gynecologist | Q7698 | TX |
N | 207V00000X | Obstetrician & Gynecologist | R-8834 | IA |
Y | 207VX0201X | Gynecologic Oncologist | 5101023759 | MI |
NPI | 1134448657 |
---|---|
Provider Name | Jean Hansen Siedel |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2010 |
Last Update Date | 21/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
358109201 (MDACC) | (05) | TX |
8GA083 (MDACC) | BCBS (01) | TX |