Provider Demographics
NPI:1942500319
Name:SIEVEKING PLASTIC SURGERY
Entity Type:Organization
Organization Name:SIEVEKING PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:ERIK
Authorized Official - Last Name:SIEVEKING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-321-1010
Mailing Address - Street 1:204 23RD AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1502
Mailing Address - Country:US
Mailing Address - Phone:615-321-1010
Mailing Address - Fax:615-321-0022
Practice Address - Street 1:204 23RD AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1502
Practice Address - Country:US
Practice Address - Phone:615-321-1010
Practice Address - Fax:615-321-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3859542Medicare PIN
TNH31769Medicare UPIN