Provider Demographics
NPI:1346357621
Name:VINIEGRA-SIBAL, AMABEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:AMABEL
Middle Name:C
Last Name:VINIEGRA-SIBAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 JENNICK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-4904
Mailing Address - Country:US
Mailing Address - Phone:804-524-0055
Mailing Address - Fax:804-524-0069
Practice Address - Street 1:301 JENNICK DR
Practice Address - Street 2:SUITE A
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-4904
Practice Address - Country:US
Practice Address - Phone:804-524-0055
Practice Address - Fax:804-524-0069
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054319208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5871113OtherAETNA
VA9720166OtherCIGNA
VA010038677Medicaid
VA463943OtherANTHEM