MEDICARE: BARRY G SIEGEL MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	BS045655	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164625687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARRY G SIEGEL MD PC

Provider Business Mailing Address
First Line	:	200 DIVERSION ST STE 150
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-2245
Country	:	US
Telephone Number	:	248-651-4200
Fax Number	:	248-258-5112

Provider Business Practice Location Address
First Line	:	200 DIVERSION ST STE 150
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-2245
Country	:	US
Telephone Number	:	248-651-4200
Fax Number	:	248-258-5112

Authorized Official
Title or Position	:	MD
Name	:	DR. BARRY G SIEGEL
Credential	:	MD
Telephone Number	:	248-651-4200

Provider Enumeration Date	:	06/11/2007
Last Update Date	:	12/30/2010

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