Healthcare Provider Details

I. General information

NPI: 1447461108
Provider Name (Legal Business Name): MARGARET HOLLISTER SIGMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 03/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5924 HARBOUR PARK DR
MIDLOTHIAN VA
23112-2163
US

IV. Provider business mailing address

5924 HARBOUR PARK DR
MIDLOTHIAN VA
23112-2163
US

V. Phone/Fax

Practice location:
  • Phone: 804-739-9005
  • Fax: 804-739-9006
Mailing address:
  • Phone: 804-739-9005
  • Fax: 804-739-9006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number200801988
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number0101253799
License Number StateVA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier21474
Identifier TypeMEDICAID
Identifier StateLA
Identifier Issuer
# 2
Identifier5910944
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: