Provider Demographics
NPI:1972513935
Name:SIEGEL, MARC E (MD)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:E
Last Name:SIEGEL
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 1:599 SHORE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2400
Mailing Address - Country:US
Mailing Address - Phone:099-268-3536
Mailing Address - Fax:855-451-0550
Practice Address - Street 1:599 SHORE RD STE 101
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2400
Practice Address - Country:US
Practice Address - Phone:099-268-3536
Practice Address - Fax:855-451-0550
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0204048010207V00000X
NJ25MA11036900207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G10169Medicare UPIN