Provider Demographics
NPI:1275751695
Name:SIGAFOOSE CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:SIGAFOOSE CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAUN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIGAFOOSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-679-0022
Mailing Address - Street 1:2005 PULASKI HWY
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040
Mailing Address - Country:US
Mailing Address - Phone:410-679-0022
Mailing Address - Fax:410-676-8109
Practice Address - Street 1:2005 PULASKI HWY
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040
Practice Address - Country:US
Practice Address - Phone:410-679-0022
Practice Address - Fax:410-676-8109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01393111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDW0880001OtherBCBS PROVIDER
MD41047501OtherBCBS RENDERING
MDM770Medicare UPIN
MD41047501OtherBCBS RENDERING