Healthcare Provider Details

I. General information

NPI: 1457356693
Provider Name (Legal Business Name): TIMOTHY HALL SIGMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 MONROE ST BLDG A
SYLVANIA OH
43560-2263
US

IV. Provider business mailing address

5800 MONROE ST BLDG A
SYLVANIA OH
43560-2263
US

V. Phone/Fax

Practice location:
  • Phone: 419-885-8449
  • Fax: 419-882-7621
Mailing address:
  • Phone: 419-885-8449
  • Fax: 419-882-7621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number35063895S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: