Provider Demographics
NPI:1033769237
Name:SIEG, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SIEG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 MADRE DE DIOS ST
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33983-4253
Mailing Address - Country:US
Mailing Address - Phone:941-268-7251
Mailing Address - Fax:
Practice Address - Street 1:84 MADRE DE DIOS ST
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33983-4253
Practice Address - Country:US
Practice Address - Phone:941-268-7251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider