Provider Demographics
NPI:1881675601
Name:SIEGEL, ARTHUR J (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:J
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-855-2358
Mailing Address - Fax:617-855-3731
Practice Address - Street 1:115 MILL ST
Practice Address - Street 2:MCLEAN HOSPITAL
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-9106
Practice Address - Country:US
Practice Address - Phone:617-855-2358
Practice Address - Fax:617-855-3731
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA30958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA710005OtherTUFTS HEALTH PLAN
MAL20009OtherBCBS MA
MA2029332Medicaid
MA2029332Medicaid
MAL20009Medicare PIN