Healthcare Provider Details
I. General information
NPI: 1972568723
Provider Name (Legal Business Name): SIRI S AKAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/17/2006
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6500 RED HOOK PLZ STE 205
ST THOMAS VI
00802-1346
US
IV. Provider business mailing address
6500 RED HOOK PLZ STE 205
ST THOMAS VI
00802-1346
US
V. Phone/Fax
- Phone: 340-775-2303
- Fax: 855-279-4420
- Phone: 340-775-2303
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 1377 |
| License Number State | VI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | ME77806 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: