Provider Demographics
NPI:1346258738
Name:SIEGEL, BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:705 MARKETPLACE PLZ STE 200
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-1841
Mailing Address - Country:US
Mailing Address - Phone:970-879-6663
Mailing Address - Fax:970-871-1234
Practice Address - Street 1:705 MARKETPLACE PLZ
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-1800
Practice Address - Country:US
Practice Address - Phone:303-422-7991
Practice Address - Fax:303-422-7994
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO38865207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ139126Medicaid
CO78426871Medicaid
CO78426871Medicaid