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Individual

MARC S SIEGEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
120 PROFESSIONAL PARK DR, STE 7, BLACKSBURG, VA 24060
(540) 552-3601
(540) 552-7585
Mailing address
120 PROFESSIONAL PARK DR, STE 7, BLACKSBURG, VA 24060
(540) 552-3601
(540) 552-7585

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101036792
VA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
0101036792
VA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
0101036792
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1356316178
VA
Enumeration date
02/23/2006
Last updated
04/13/2012
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