Provider Demographics
NPI:1235114372
Name:SIEGERT, CLAUDINE E (MD)
Entity Type:Individual
Prefix:MS
First Name:CLAUDINE
Middle Name:E
Last Name:SIEGERT
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 1:8055 MAYFIELD RD STE 105
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2447
Mailing Address - Country:US
Mailing Address - Phone:440-214-8026
Mailing Address - Fax:216-201-7963
Practice Address - Street 1:6847 N CHESTNUT ST STE 330
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3929
Practice Address - Country:US
Practice Address - Phone:330-235-7430
Practice Address - Fax:330-235-7432
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2001-00782208600000X
OH35.134546208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7041146OtherAETNA
NCP01176391OtherRAILROAD MCR
NC8912897Medicaid
NCH23292Medicare UPIN
NCNCB752AMedicare PIN
NC288028Medicare PIN