Provider Demographics
NPI:1598852444
Name:DAIGLE, SEEMA NASREEN (MD)
Entity Type:Individual
Prefix:
First Name:SEEMA
Middle Name:NASREEN
Last Name:DAIGLE
Suffix:
Gender:F
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:181 DANIEL RD
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-7151
Practice Address - Country:US
Practice Address - Phone:828-286-9036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200101122207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC110225959OtherMEDICARE RAILROAD
NC1598852444Medicaid
NC89129VKMedicaid
NC129VKOtherBC/BS OF NC
SCN01125Medicaid
NC110225959OtherMEDICARE RAILROAD
NC1598852444Medicaid
NC2290687Medicare PIN