MEDICARE: DR. JOSEPH MICHAEL SIERRA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	32817	MN

General Provider Information

NPI Number	:	1710950936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH MICHAEL SIERRA MD

Provider Business Mailing Address
First Line	:	8501 133RD ST W
Second Line	:
City	:	APPLE VALLEY
State	:	MN
Zip	:	55124-9504
Country	:	US
Telephone Number	:	952-431-6918
Fax Number	:

Provider Business Practice Location Address
First Line	:	8501 133RD ST W
Second Line	:
City	:	APPLE VALLEY
State	:	MN
Zip	:	55124-9504
Country	:	US
Telephone Number	:	952-431-6918
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	11/02/2018

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