Provider Demographics
NPI:1114926979
Name:VIGDER, PATRICIA NICHOLETTE (DO)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:NICHOLETTE
Last Name:VIGDER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 CONSTITUTION BLVD
Mailing Address - Street 2:UPPER LEVEL
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1278
Mailing Address - Country:US
Mailing Address - Phone:724-843-0737
Mailing Address - Fax:724-770-7922
Practice Address - Street 1:2620 CONSTITUTION BLVD
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1278
Practice Address - Country:US
Practice Address - Phone:724-843-0737
Practice Address - Fax:724-770-7922
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-7995-V207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
341931777OtherPPO NEXT
34193177700OtherWORKERS COMP.
4639496OtherAETNA
160060013OtherRAILROAD MEDICARE
5385264OtherCIGNA/HEALTHSOURCE
001676353OtherHIGHMARK
07-04473OtherUHC
OH2380918Medicaid
341931777DOtherAULTCARE
0000000270699OtherANTHEM
341931777OtherHEALTH ASSURANCE/HE
341931777PVOtherSUMMA CARE
799782OtherGREAT WEST HEALTH
34193177700OtherWORKERS COMP.
0000000270699OtherANTHEM
160060013OtherRAILROAD MEDICARE
PA270530LCNMedicare PIN