Provider Demographics
NPI:1225147267
Name:SIGAL, ROBERT K (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:K
Last Name:SIGAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 SAMUEL MORSE DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5317
Mailing Address - Country:US
Mailing Address - Phone:703-893-6168
Mailing Address - Fax:703-790-3444
Practice Address - Street 1:1825 SAMUEL MORSE DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5317
Practice Address - Country:US
Practice Address - Phone:703-893-6168
Practice Address - Fax:703-790-3444
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050666174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA028774Medicaid
VA463704OtherANTHEM NON-PAR PROVIDER
VA92515Medicaid
VAF86927Medicare UPIN
VA463704OtherANTHEM NON-PAR PROVIDER