Siegel, Mark

Siegel, Mark is an individual health care provider with primary practice located at 1220 Dewey Ave. , Wauwatosa WI 53213-2504. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Siegel, Mark can be contacted via phone (414) 454-6566.

Contact Information

Primary practice address
1220 Dewey Ave. Wauwatosa WI 53213-2504
Phone: (414) 454-6566
Fax: (414) 454-6522
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 23242020 Wisconsin
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 23242020 Wisconsin
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 23242-020 Wisconsin
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 23240-020 Wisconsin

Profile Details

NPI number 1649322595
LBN Legal business name Siegel, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2007
Last updated Dec 20th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649322595 NPPES
Wisconsin MEDICAID 30525800

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