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General NPI Number Information
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NPI Number | 1679796726
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Entity Type | Individual
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Provider Name | BRIAN MICHAEL SIEGEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 1010 WINDSOR RD
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City | PIKESVILLE
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State | MD
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Zip | 21208-4762
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Country | US
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Telephone | 410-484-6484
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Fax |
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Provider Business Mailing Address
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Address Line | 205 E JOPPA RD SUITE 103
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City | TOWSON
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State | MD
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Zip | 21286-3260
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Country | US
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Telephone | 410-296-3448
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Fax | 410-296-3695
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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 | 2084D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
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License Number | D30195
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 307185
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License Number State | LA
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