Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 013476 | LA |
N | 207RC0000X | Internist - Cardiovascular Disease | 13476 | LA |
N | 207RC0000X | Internist - Cardiovascular Disease | MD.013476 | LA |
Y | 207RI0011X | Interventional Cardiology | 0101259587 | VA |
N | 207RI0011X | Interventional Cardiology | MD.013476 | LA |
NPI | 1023017928 |
---|---|
Provider Name | Lewis Alan Siegel |
First Address | Fishersville, VA 22939-0388 |
Second Address | Fishersville, VA 22939-2332 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2005 |
Last Update Date | 23/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00015081 | (05) | MS |
060016777 | (02) | LA |
060016777 | MEDICARE RAILROAD (01) | LA |
1320579 | (05) | LA |
B60923 | (02) | LA |