MEDICARE: DR. THOMAS S SIEGEL M.D.

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	2086S0129X	Vascular Surgery Physician	040981	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821069303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS S SIEGEL M.D.

Provider Business Mailing Address
First Line	:	18181 OAKWOOD BLVD
Second Line	:	SUITE 307
City	:	DEARBORN
State	:	MI
Zip	:	48124-5032
Country	:	US
Telephone Number	:	313-593-0810
Fax Number	:	313-593-3059

Provider Business Practice Location Address
First Line	:	18181 OAKWOOD BLVD
Second Line	:	SUITE 307
City	:	DEARBORN
State	:	MI
Zip	:	48124-5032
Country	:	US
Telephone Number	:	313-593-0810
Fax Number	:	313-593-3059

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	03/25/2008

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