Provider Demographics
NPI:1609230200
Name:SEDIGH HAGHIGHAT, GILLIAN BACH (MD)
Entity Type:Individual
Prefix:
First Name:GILLIAN
Middle Name:BACH
Last Name:SEDIGH HAGHIGHAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GILLIAN
Other - Middle Name:NOEL
Other - Last Name:BACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:103 HAWS LN
Mailing Address - Street 2:
Mailing Address - City:FLOURTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19031-2063
Mailing Address - Country:US
Mailing Address - Phone:404-358-2665
Mailing Address - Fax:215-662-2875
Practice Address - Street 1:111 S 11TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4824
Practice Address - Country:US
Practice Address - Phone:215-955-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-09
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD466291207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine