Provider Demographics
NPI:1629114277
Name:ZIEGENBEIN, MARTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTINA
Middle Name:
Last Name:ZIEGENBEIN
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 1:148 HIGHWAY 105 EXT
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5681
Mailing Address - Country:US
Mailing Address - Phone:828-386-2746
Mailing Address - Fax:828-386-2750
Practice Address - Street 1:148 HWY 105 EXT
Practice Address - Street 2:SUITE 104
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607
Practice Address - Country:US
Practice Address - Phone:828-386-2746
Practice Address - Fax:828-386-2750
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201501979207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34913300Medicaid
WI047B72200Medicare PIN