Individual
CASANA RAE SIEBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 W 2ND ST, BLOOMINGTON, IN 47403-2317
(812) 353-6821
Mailing address
315 W KIRKWOOD AVE, APT 407, BLOOMINGTON, IN 47404-5175
(316) 213-4738
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
6580
KS
208M00000X
Hospitalist Physician
Primary
01074372A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457572596
NPI
KS
Enumeration date
05/02/2007
Last updated
03/10/2020
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