Provider Demographics
NPI:1447461108
Name:SIGMAN, MARGARET HOLLISTER
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:HOLLISTER
Last Name:SIGMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5924 HARBOUR PARK DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2163
Mailing Address - Country:US
Mailing Address - Phone:804-739-9005
Mailing Address - Fax:804-739-9006
Practice Address - Street 1:5924 HARBOUR PARK DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2163
Practice Address - Country:US
Practice Address - Phone:804-739-9005
Practice Address - Fax:804-739-9006
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200801988208000000X
390200000X
VA0101253799207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA21474Medicaid
NC5910944Medicaid
NC2073555Medicare PIN
NC5910944Medicaid
LA21474Medicaid