Provider Demographics
NPI:1750390316
Name:SIGUE, GERARD FITZGERALD (MD)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:FITZGERALD
Last Name:SIGUE
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 1:2308 E MAIN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-4041
Mailing Address - Country:US
Mailing Address - Phone:337-608-9043
Mailing Address - Fax:
Practice Address - Street 1:217 GLENEAGLES CIR
Practice Address - Street 2:
Practice Address - City:BROUSSARD
Practice Address - State:LA
Practice Address - Zip Code:70518-6185
Practice Address - Country:US
Practice Address - Phone:337-608-9043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022140207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1676543Medicaid
LA5W676Medicare ID - Type Unspecified
LA1676543Medicaid