=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649255126
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANNE E ZIEGLER MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/07/2005
-----------------------------------------------------
Last Update Date | 08/14/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 202 MAPLEWOOD AVE ATTN: ANESTHESIA
-----------------------------------------------------
City | RONCEVERTE
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 24970-1334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-647-4411
-----------------------------------------------------
Fax | 304-647-6076
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 202 MAPLEWOOD AVENUE ATTN: ANESTHESIA
-----------------------------------------------------
City | RONCEVERTE
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 24970-1334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-647-4411
-----------------------------------------------------
Fax | 304-647-6076
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | MD051704L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 26190
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------