Healthcare Provider Details

I. General information

NPI: 1174539787
Provider Name (Legal Business Name): DONNA M SIGL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 YALE BLVD NE CIMARRON CLINIC- PROGRAMS FOR CHILDREN - ADOLESCENTS
ALBUQUERQUE NM
87106-3825
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-0371
  • Fax:
Mailing address:
  • Phone: 505-272-1476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2001-102
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: