Healthcare Provider Details

I. General information

NPI: 1043521958
Provider Name (Legal Business Name): MARGARET ANNE SIEGEL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAGGIE PETERSON

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 6TH AVE EMERGENCY DEPARTMENT
DES MOINES IA
50314-2613
US

IV. Provider business mailing address

PO BOX 4925
DES MOINES IA
50305-4925
US

V. Phone/Fax

Practice location:
  • Phone: 515-247-4445
  • Fax: 515-643-8933
Mailing address:
  • Phone: 515-247-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number002129
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: