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1891728887

NPI Code Detail

MEDICARE: CORYDON WALTER SIFFRING MD

MEDICARE: CORYDON WALTER SIFFRING 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
1	2086S0127X	Trauma Surgery Physician	EMC0002596	MI
2	2086S0127X	Trauma Surgery Physician	036144511	IL
3	208600000X	Surgery Physician	036144511	IL
4	208600000X	Surgery Physician	MD046448L	PA
5	2086S0127X	Trauma Surgery Physician	MD046448L	PA
6	208600000X	Surgery Physician	MC-2223	ID
7	2086S0102X	Surgical Critical Care Physician	MD046448L	PA
8	2086S0102X	Surgical Critical Care Physician	036144511	IL
9	2086S0102X	Surgical Critical Care Physician	41749	TN

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	:	1891728887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORYDON WALTER SIFFRING MD

Provider Business Mailing Address
First Line	:	971 DUTTON RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-2513
Country	:	US
Telephone Number	:	423-863-6938
Fax Number	:

Provider Business Practice Location Address
First Line	:	3401 LUDINGTON ST
Second Line	:
City	:	ESCANABA
State	:	MI
Zip	:	49829-1300
Country	:	US
Telephone Number	:	906-786-5707
Fax Number	:	217-757-6573

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	03/02/2026

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Directions to “ CORYDON WALTER SIFFRING MD” Practice Location

Language	Start Address	Practice Location

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