Provider Demographics
NPI:1073544995
Name:FIEBIGER, SIRI J (MD)
Entity Type:Individual
Prefix:
First Name:SIRI
Middle Name:J
Last Name:FIEBIGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-5000
Mailing Address - Fax:
Practice Address - Street 1:2925 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1321
Practice Address - Country:US
Practice Address - Phone:612-863-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5961207V00000X
MN44323207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND28132FIOtherMNBS #
NDND200016OtherLHS #
ND142008OtherUCARE #
ND10283OtherNDBS #
ND2250OtherSIOUX VALLEY #
ND0702341OtherMEDICA #
ND4703OtherNDBS #
ND900855OtherAMERICA'S PPO/ARAZ #
ND16449Medicaid
ND6D408FIOtherMNBS #
NDDA9011015532OtherPREFERRED ONE #
ND197002000Medicaid
ND0701548OtherMEDICA #
NDHP19513OtherHEALTHPARTNERS #
NDND200016OtherLHS #
ND142008OtherUCARE #
ND160002092Medicare ID - Type UnspecifiedMN MEDICARE #
ND900855OtherAMERICA'S PPO/ARAZ #
ND4703Medicare ID - Type UnspecifiedND MEDICARE #