Healthcare Provider Details

I. General information

NPI: 1790788479
Provider Name (Legal Business Name): CARA B SIEGEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 10/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 EDWARDS MILL RD SUITE 200
RALEIGH NC
27612-5243
US

IV. Provider business mailing address

3001 EDWARDS MILL RD SUITE 200
RALEIGH NC
27612-5243
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-5600
  • Fax: 919-863-6821
Mailing address:
  • Phone: 919-781-5600
  • Fax: 919-863-6821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number95-00222
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: