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NPI Code Detail

MEDICARE: DR. TYLER EDWARD SIEKMANN MD

MEDICARE: DR. TYLER EDWARD SIEKMANN MD
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
1207P00000XEmergency Medicine Physician2021-02116NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10OTHERNONE

General Provider Information

NPI Number : 1457856015
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TYLER EDWARD SIEKMANN MD
Provider Business Mailing Address
First Line : CAROLINAS MEDICAL CENTER
Second Line : 1000 BLYTHE BLVD
City : CHARLOTTE
State : NC
Zip : 28203
Country : US
Telephone Number : 704-355-3181
Fax Number :
Provider Business Practice Location Address
First Line : 1000 BLYTHE BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-5871
Country : US
Telephone Number : 704-355-3181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2018
Last Update Date : 07/08/2021

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