Healthcare Provider Details

I. General information

NPI: 1598861791
Provider Name (Legal Business Name): ROBERT SIEFRING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 10/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 BURLINGTON MOUNT HOLLY RD STE D BURLINGTON PROFESSIONAL CAMPUS (RTE 541)
BURLINGTON NJ
08016-4722
US

IV. Provider business mailing address

3 COOPER PLZ SUITE 502
CAMDEN NJ
08103-1438
US

V. Phone/Fax

Practice location:
  • Phone: 609-835-5570
  • Fax:
Mailing address:
  • Phone: 856-963-6888
  • Fax: 856-968-8499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMA40773
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: