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General NPI Number Information
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NPI Number | 1295706695
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Entity Type | Individual
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Provider Name | THERESA SIEGERT M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12300 N PORT WASHINGTON RD
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City | MEQUON
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State | WI
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Zip | 53092-3339
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Country | US
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Telephone | 262-243-5400
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Fax | 262-243-6005
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Provider Business Mailing Address
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Address Line | 12300 N PORT WASHINGTON RD
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City | MEQUON
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State | WI
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Zip | 53092-3339
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Country | US
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Telephone | 262-243-5400
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Fax | 262-243-6005
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 25432
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License Number State | WI
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