Healthcare Provider Details
I. General information
NPI: 1982729745
Provider Name (Legal Business Name): CAREY NEAL SIGAFOOSE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/20/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3500 BOSTON ST SUITE 322 MS- #70
BALTIMORE MD
21224-5251
US
IV. Provider business mailing address
3155 BIRCH BROOK LN
ABINGDON MD
21009-2735
US
V. Phone/Fax
- Phone: 410-534-5900
- Fax: 410-534-5907
- Phone: 410-534-5900
- Fax: 410-534-5907
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NX0800X |
| Taxonomy | Orthopedic Chiropractor |
| License Number | S01864 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: