Provider Demographics
NPI:1225220320
Name:SIGMOND, BENJAMIN R (MD, CWS)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:R
Last Name:SIGMOND
Suffix:
Gender:M
Credentials:MD, CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 INNOVATION DR STE 3136
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-8815
Mailing Address - Country:US
Mailing Address - Phone:717-741-3449
Mailing Address - Fax:717-741-5496
Practice Address - Street 1:2494 BERNVILLE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9469
Practice Address - Country:US
Practice Address - Phone:610-378-7900
Practice Address - Fax:610-378-1952
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0497208600000X
OH35099820208600000X
PAMD427801208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0076920Medicaid
OH0076920Medicaid