Provider Demographics
NPI:1356442263
Name:SHELDON N. SIEGEL, MD,PC.
Entity Type:Organization
Organization Name:SHELDON N. SIEGEL, MD,PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:N
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-844-8192
Mailing Address - Street 1:1701 SOUTH BLVD E
Mailing Address - Street 2:SUITE B-50
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-6122
Mailing Address - Country:US
Mailing Address - Phone:248-844-8192
Mailing Address - Fax:248-844-8259
Practice Address - Street 1:1701 SOUTH BLVD E
Practice Address - Street 2:SUITE B-50
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-6122
Practice Address - Country:US
Practice Address - Phone:248-844-8192
Practice Address - Fax:248-844-8259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0232602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB43358Medicare UPIN
MI0638166Medicare ID - Type Unspecified