Provider Demographics
NPI:1104820182
Name:SIEGEL, DAVID L (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14999 HEALTH CENTER DR
Mailing Address - Street 2:STE 201
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1087
Mailing Address - Country:US
Mailing Address - Phone:301-262-8188
Mailing Address - Fax:301-464-8233
Practice Address - Street 1:14999 HEALTH CENTER DR
Practice Address - Street 2:STE 201
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1087
Practice Address - Country:US
Practice Address - Phone:301-262-8188
Practice Address - Fax:301-464-8233
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2021-10-13
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Provider Licenses
StateLicense IDTaxonomies
MDD26190207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD982841900Medicaid
MDC61430Medicare UPIN
MD982841900Medicaid