Siegel, Mark
Siegel, Mark is an individual health care provider with primary practice located at 1220 Dewey Ave. , Wauwatosa WI 53213-2504. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Siegel, Mark can be contacted via phone (414) 454-6566.Contact Information
Primary practice address
1220 Dewey Ave.
Wauwatosa WI 53213-2504
Phone: (414) 454-6566
Fax: (414) 454-6522
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 23242020 | Wisconsin |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 23242020 | Wisconsin |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 23242-020 | Wisconsin |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 23240-020 | Wisconsin |
Profile Details
| NPI number | 1649322595 |
|---|---|
| LBN Legal business name | Siegel, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2007 |
| Last updated | Dec 20th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649322595 | NPPES |
| Wisconsin | MEDICAID | 30525800 |
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