Provider Demographics
NPI:1235107707
Name:SIEFMAN, MICHAEL A (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:SIEFMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 RADIO RD
Mailing Address - Street 2:STE 105
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-3740
Mailing Address - Country:US
Mailing Address - Phone:239-261-9199
Mailing Address - Fax:239-261-9399
Practice Address - Street 1:3940 RADIO RD
Practice Address - Street 2:STE 105
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-3740
Practice Address - Country:US
Practice Address - Phone:239-261-9199
Practice Address - Fax:239-261-9399
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCHO4822111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70819Medicare ID - Type Unspecified
FLT55055Medicare UPIN