Provider Demographics
NPI:1578560686
Name:SIEVING, RICHARD R (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:R
Last Name:SIEVING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 SE 165TH MULBERRY LN
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-5884
Mailing Address - Country:US
Mailing Address - Phone:352-674-5060
Mailing Address - Fax:352-674-5001
Practice Address - Street 1:8900 SE 165TH MULBERRY LN
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5884
Practice Address - Country:US
Practice Address - Phone:352-674-5060
Practice Address - Fax:352-674-5001
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME58805207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME58805OtherSTATE MEDICAL LICENSE
FLP00357447OtherMEDICARE RR
FL1930642OtherCIGNA
FLCF1416OtherMEDICARE RR GROUP
FL10721084OtherCAQH
FL269859500OtherMEDICAID GROUP
FL77940OtherBCBS OF FL GROUP ID
FL278475100Medicaid
FL42792OtherBCBS OF FL
FL77940OtherMEDICARE GROUP ID
FL1930642OtherCIGNA
FLCF1416OtherMEDICARE RR GROUP