Individual
DR. GARY RICHARD SIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
933 FIRST COLONIAL RD, SUITE 100, VIRGINIA BEACH, VA 23454-3172
(757) 491-7359
(757) 491-9359
Mailing address
933 FIRST COLONIAL RD, SUITE 100, VIRGINIA BEACH, VA 23454-3172
(757) 491-7359
(757) 491-9359
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101035397
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006064833
VIRGINIA PREMIER
VA
05
—
006064833
—
VA
01
—
030161
ANTHEM BCBS
VA
01
—
228987
UHC/MDIPA/OPC/MAMSI
VA
01
—
7906796
NC MEDICAID
NC
01
—
97565
OPTIMA/SENTARA
VA
Enumeration date
10/06/2005
Last updated
04/10/2015
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