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General NPI Number Information
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NPI Number | 1023104973
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Entity Type | Organization
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Legal Business Name | THOMAS S. SIEGEL, M.D.P.C.
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 18181 OAKWOOD BLVD SUITE 307
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City | DEARBORN
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State | MI
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Zip | 48124-5032
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Country | US
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Telephone | 313-593-0810
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Fax | 313-593-3059
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Provider Business Mailing Address
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Address Line | 18181 OAKWOOD BLVD SUITE 307
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City | DEARBORN
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State | MI
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Zip | 48124-5032
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Country | US
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Telephone | 313-593-0810
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Fax | 313-593-3059
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS S. SIEGEL
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Credential | M.D.
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Telephone | 313-593-0810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 40981
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License Number State | MI
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