Provider Demographics
NPI:1649242512
Name:DIGEL, MARY CAROL (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CAROL
Last Name:DIGEL
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 1:214 DOCTORS ST
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NC
Mailing Address - Zip Code:28675
Mailing Address - Country:US
Mailing Address - Phone:336-372-5606
Mailing Address - Fax:336-372-6211
Practice Address - Street 1:214 DOCTORS ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NC
Practice Address - Zip Code:28675-9247
Practice Address - Country:US
Practice Address - Phone:336-372-5606
Practice Address - Fax:336-372-6211
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32934207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
28582OtherNCBCBS
0107813OtherUNITED HEALTHCARE
36714OtherMEDCOST
5000OtherPARTNERS
VA5603609Medicaid
NC8928582Medicaid
E39273Medicare UPIN
28582OtherNCBCBS