Provider Demographics
NPI:1285733162
Name:SIGAL, YAKOV M (MD)
Entity type:Individual
Prefix:DR
First Name:YAKOV
Middle Name:M
Last Name:SIGAL
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:B240 LIFE SCIENCES BLDG
Mailing Address - Street 2:DEPT OF PEDIATRICS & HUMAN MEDICINE
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824
Mailing Address - Country:US
Mailing Address - Phone:517-355-3308
Mailing Address - Fax:
Practice Address - Street 1:A110 CLINICAL CTR
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-1313
Practice Address - Country:US
Practice Address - Phone:517-353-3003
Practice Address - Fax:517-353-5514
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2012-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301068787208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1285733162Medicaid
MI4112972Medicaid
MIG97742Medicare UPIN
MIC36092067Medicare PIN