Individual
DR. HEIDI TABB SIUTA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
21 CROSSROADS DR, STE 100, OWINGS MILLS, MD 21117-5441
(410) 356-8186
(410) 356-4180
Mailing address
10373A REISTERSTOWN RD, OWINGS MILLS, MD 21117-3617
(410) 356-8186
(410) 356-4180
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D0050436
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2849
B/C B/S
DC
01
—
J062
B/C B/S
MD
01
—
KA80
B/C B/S
MD
Enumeration date
02/02/2006
Last updated
07/09/2007
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