Healthcare Provider Details

I. General information

NPI: 1174518344
Provider Name (Legal Business Name): DANIEL O SIEGEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E 9TH AVE #720 S
DENVER CO
80220
US

IV. Provider business mailing address

4500 E 9TH AVE #720 S
DENVER CO
80220
US

V. Phone/Fax

Practice location:
  • Phone: 303-355-3525
  • Fax: 303-355-0255
Mailing address:
  • Phone: 303-355-3525
  • Fax: 303-355-0255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35377
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35377
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: