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General NPI Number Information
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NPI Number | 1366036386
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Entity Type | Individual
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Provider Name | GEORGE FREDERICK SIEGRIST
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Gender | Male
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Dates
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Enumeration Date | 02/22/2021
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 1120 20TH ST. NW BLDG. 1 NORTH, FLOOR 1
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City | WASHINGTON
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State | DC
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Zip | 20036
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Country | US
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Telephone | 202-981-7711
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Fax |
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Provider Business Mailing Address
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Address Line | 200 DALE DR
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City | ROCKVILLE
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State | MD
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Zip | 20850-2815
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Country | US
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Telephone | 301-518-3957
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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