Provider Demographics
NPI:1467498881
Name:SEIBERT, DONALD GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:GEORGE
Last Name:SEIBERT
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 1:202 DUKE OF GLOUCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014
Mailing Address - Country:US
Mailing Address - Phone:540-345-4900
Mailing Address - Fax:540-345-4179
Practice Address - Street 1:202 DUKE OF GLOUCHESTER ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014
Practice Address - Country:US
Practice Address - Phone:540-345-4900
Practice Address - Fax:540-345-4179
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231677207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5869030Medicaid
VA5869030Medicaid
VA100000296Medicare ID - Type Unspecified