Provider Demographics
NPI:1477749984
Name:JOEL SIEGEL, M.D.
Entity Type:Organization
Organization Name:JOEL SIEGEL, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-225-1505
Mailing Address - Street 1:101 E REDLANDS BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4775
Mailing Address - Country:US
Mailing Address - Phone:909-335-8649
Mailing Address - Fax:909-557-1924
Practice Address - Street 1:150 W BEAU ST
Practice Address - Street 2:SUITE 308
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4425
Practice Address - Country:US
Practice Address - Phone:724-225-1505
Practice Address - Fax:724-225-5810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024578E207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA432253OtherBCBS PROVIDER NUMBER
PA432253OtherBCBS PROVIDER NUMBER
=========OtherTAX ID NUMBER
PA432253OtherBCBS PROVIDER NUMBER