Provider Demographics
NPI:1568026623
Name:SIWICKI, ALANA PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:PATRICIA
Last Name:SIWICKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22201 MOROSS RD STE 370
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2176
Mailing Address - Country:US
Mailing Address - Phone:313-343-4585
Mailing Address - Fax:313-343-7126
Practice Address - Street 1:22201 MOROSS RD STE 370
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2176
Practice Address - Country:US
Practice Address - Phone:313-343-4585
Practice Address - Fax:313-343-7126
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351046446207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology