Provider Demographics
NPI:1467987008
Name:SIEG, ROBERT (PHARM D)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SIEG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DODGE CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55927-9112
Mailing Address - Country:US
Mailing Address - Phone:507-292-1475
Mailing Address - Fax:507-292-1740
Practice Address - Street 1:25 25TH ST SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-5576
Practice Address - Country:US
Practice Address - Phone:507-292-1475
Practice Address - Fax:507-292-1740
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN120816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist