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General NPI Number Information
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NPI Number | 1164625687
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Entity Type | Organization
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Legal Business Name | BARRY G SIEGEL MD PC
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 12/30/2010
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Provider Practice Location Address
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Address Line | 200 DIVERSION ST STE 150
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-2245
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Country | US
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Telephone | 248-651-4200
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Fax | 248-258-5112
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Provider Business Mailing Address
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Address Line | 200 DIVERSION ST STE 150
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-2245
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Country | US
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Telephone | 248-651-4200
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Fax | 248-258-5112
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Authorized Official
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Title or Position | MD
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Name | DR. BARRY G SIEGEL
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Credential | MD
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Telephone | 248-651-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | BS045655
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License Number State | MI
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