MEDICARE: DR. GABRIEL SIEGEL 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	207P00000X	Emergency Medicine Physician	04-50838	KS
2	207P00000X	Emergency Medicine Physician	DR.0069537	CO

General Provider Information

NPI Number	:	1891322327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GABRIEL SIEGEL MD

Provider Business Mailing Address
First Line	:	777 BANNOCK ST # MC0108
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-4507
Country	:	US
Telephone Number	:	303-602-5176
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 BANNOCK ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-4507
Country	:	US
Telephone Number	:	303-602-2715
Fax Number	:

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

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	04/22/2026

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