Individual
KATHY SIESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
7000 EUCLID AVE, SUITE 101, CLEVELAND, OH 44103-4014
(216) 231-5612
(216) 721-5534
Mailing address
7000 EUCLID AVE, SUITE 101, CLEVELAND, OH 44103-4014
(216) 231-5612
(216) 721-5534
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36-00-2592-S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0875101
—
OH
05
—
1563848
—
OH
01
—
480031292
RR MEDICARE CFAC
OH
01
—
CH5179
RR MEDICARE GROUP CFAC
OH
01
—
P00065177
RR MEDICARE
OH
Enumeration date
06/22/2005
Last updated
02/26/2013
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