Provider Demographics
NPI:1922033679
Name:SIEGEL, DONALD C (MD,FACS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:C
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:MD,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2801 N DECATUR RD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5949
Mailing Address - Country:US
Mailing Address - Phone:404-297-0098
Mailing Address - Fax:404-292-5609
Practice Address - Street 1:2801 N DECATUR RD
Practice Address - Street 2:SUITE 180
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5949
Practice Address - Country:US
Practice Address - Phone:404-297-0098
Practice Address - Fax:404-292-5609
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11475208600000X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000137662AMedicaid
GA000137662AMedicaid