Healthcare Provider Details

I. General information

NPI: 1467456202
Provider Name (Legal Business Name): LAURA J SIEMS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 04/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 PLUM ST
WILLIAMSBURG PA
16693-1116
US

IV. Provider business mailing address

6642 OAK DR
HUNTINGDON PA
16652-6952
US

V. Phone/Fax

Practice location:
  • Phone: 814-832-3405
  • Fax: 814-832-3811
Mailing address:
  • Phone: 814-644-0353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD066187L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD066187L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: