Healthcare Provider Details

I. General information

NPI: 1912986746
Provider Name (Legal Business Name): JESSICA E SIGEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 09/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7730 FIRST PL SUITE A
OAKWOOD VILLAGE OH
44146-6719
US

IV. Provider business mailing address

7111 FAIRWAY DR #400
PALM BEACH GARDENS FL
33418-4204
US

V. Phone/Fax

Practice location:
  • Phone: 440-703-2100
  • Fax: 440-703-2100
Mailing address:
  • Phone: 800-330-6565
  • Fax: 800-330-6565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number35.074471
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number35.074471
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: