| Doctor Name: | DR. DERRICK ROBSON SIEBERT |
| NPI Number: | 1063674224 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 61877 - 20 |
| Business Practice Address: | 333 Pine Ridge Blvd Wausau, WI - 544014120 |
| Business Phone Number: | 7158472283 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1324, WAUSAU |
| State: | WI |
| Postal Code: | 544021324 |
| Phone Number: | 4145591273 |
| Fax Number: | |
| NPI Enumeration Date: | 06/30/2008 |
| NPI Last Update Date: | 06/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0204X |
| License Number: | 61877 - 20 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Vascular & Interventional Radiology |
| Taxonomy Definition: | A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |