Provider Demographics
NPI:1578526752
Name:SIGEL, GEORGE STANLEY (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:STANLEY
Last Name:SIGEL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 HIGH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-0574
Mailing Address - Country:US
Mailing Address - Phone:781-762-3987
Mailing Address - Fax:
Practice Address - Street 1:20 HIGH ST STE 1
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-0574
Practice Address - Country:US
Practice Address - Phone:781-762-3987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA311042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303511Medicaid
MAM13635Medicare ID - Type Unspecified
MA1303511Medicaid