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General NPI Number Information
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NPI Number | 1578562617
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Entity Type | Individual
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Provider Name | EVAN L SIEGEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 14995 SHADY GROVE RD STE 250
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City | ROCKVILLE
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State | MD
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Zip | 20850-8726
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Country | US
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Telephone | 301-942-7600
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Fax | 301-942-3521
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Provider Business Mailing Address
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Address Line | 2730 UNIVERSITY BLVD W SUITE 310
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City | SILVER SPRING
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State | MD
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Zip | 20902-1905
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Country | US
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Telephone | 301-942-7600
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Fax | 301-942-3132
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | D0038512
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License Number State | MD
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