Provider Demographics
NPI:1457446916
Name:SIELER, SHAWN DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:DOUGLAS
Last Name:SIELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2186 STATE HIGHWAY 27
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902
Mailing Address - Country:US
Mailing Address - Phone:732-422-1222
Mailing Address - Fax:732-422-3636
Practice Address - Street 1:2186 STATE HIGHWAY 27
Practice Address - Street 2:SUITE 1A
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902
Practice Address - Country:US
Practice Address - Phone:732-422-1222
Practice Address - Fax:732-422-3636
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA59457207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG50914Medicare UPIN
NJ012822Medicare ID - Type Unspecified