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General NPI Number Information
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NPI Number | 1871834606
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Entity Type | Individual
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Provider Name | GEOFFREY MICHAEL SIEGEL D.O., F.A.O.C.D.
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Gender | Male
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 478 ALAMANDA DR
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-6508
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Country | US
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Telephone | 954-458-8709
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Fax | 954-458-8709
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Provider Business Mailing Address
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Address Line | 478 ALAMANDA DR
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-6508
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Country | US
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Telephone | 954-458-8709
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Fax | 954-458-8709
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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 | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | OS3374
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License Number State | FL
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