Individual
GARY EDWARD SIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1700 MEDICAL WAY, SNELLVILLE, GA 30078-2195
(770) 979-9996
Mailing address
PO BOX 3559, SUWANEE, GA 30024-0993
(770) 979-9996
(770) 979-1202
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036289
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
036289
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000543661G
—
GA
05
—
000543661I
—
GA
01
—
050048443
RAILROAD MEDICARE
GA
Enumeration date
11/10/2005
Last updated
06/28/2010
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