Provider Demographics
NPI:1447323761
Name:SIEGEL, JOSHUA A (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:A
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAMPTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4855
Mailing Address - Country:US
Mailing Address - Phone:603-775-7575
Mailing Address - Fax:603-778-9680
Practice Address - Street 1:1 HAMPTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4855
Practice Address - Country:US
Practice Address - Phone:603-775-7575
Practice Address - Fax:603-778-9680
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10374207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
200035206OtherRAILROAD MEDICARE
NH3076333Medicaid
200035206OtherRAILROAD MEDICARE
100833000OtherUS DEPARTMENT OF LABOR
NH30011510Medicaid
0904522OtherUNITED HEALTHCARE
NHRE4952Medicare PIN
0108405Y0NH01OtherANTHEM BS
G58323Medicare UPIN
NH0422560001Medicare NSC
2035486OtherAETNA