# MARK W SIEWERT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114982733
- **Gender:** Man
- **Credential:** PT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 2815 | MN | Yes |

## Other

- **Enumeration date:** 04/18/2006
- **Last updated:** 07/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 40B33SI | BC INDIV PROV ID | MN |
| 01 | — | 6400642 | MEDICA INDIV PROV ID | MN |