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General NPI Number Information
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NPI Number | 1801048814
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Entity Type | Individual
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Provider Name | FREDRIC A SIEGEL MD
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Gender | Male
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 9260 W SUNSET RD STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89148-4903
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Country | US
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Telephone | 702-534-5464
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Fax | 702-534-5465
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Provider Business Mailing Address
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Address Line | 6355 S BUFFALO DR FL 3
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City | LAS VEGAS
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State | NV
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Zip | 89113-2133
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Country | US
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Telephone | 702-216-3436
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Fax | 702-671-6883
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 3127
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License Number State | NV
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