Provider Demographics
NPI:1912901687
Name:VIGLIONE, CHERYL A (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:A
Last Name:VIGLIONE
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 1:119 STAUNTON DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-6064
Mailing Address - Country:US
Mailing Address - Phone:336-852-3300
Mailing Address - Fax:336-852-0651
Practice Address - Street 1:3801 W MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1301
Practice Address - Country:US
Practice Address - Phone:336-852-3300
Practice Address - Fax:336-852-0651
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC263982085N0904X, 2085R0202X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8984886Medicaid
NC8984886Medicaid
NCE68222Medicare UPIN