Basic Information
| Provider Information | |||||||||
| NPI: | 1053301168 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIWIEC | ||||||||
| FirstName: | HANNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 610 SOLAREX CT | ||||||||
| Address2: | |||||||||
| City: | FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217038624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016636162 | ||||||||
| FaxNumber: | 3016948525 | ||||||||
| Practice Location | |||||||||
| Address1: | 3430 WORTHINGTON BLVD | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217047017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2402156900 | ||||||||
| FaxNumber: | 2404366300 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2005 | ||||||||
| LastUpdateDate: | 06/17/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | D69273 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.