Provider Demographics
NPI:1306810650
Name:SIGALOVE, NOEMI M (MD)
Entity type:Individual
Prefix:
First Name:NOEMI
Middle Name:M
Last Name:SIGALOVE
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 1:2500 W UTOPIA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4172
Mailing Address - Country:US
Mailing Address - Phone:623-683-4462
Mailing Address - Fax:623-683-4963
Practice Address - Street 1:9965 N 95TH ST STE 105
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4594
Practice Address - Country:US
Practice Address - Phone:480-629-8390
Practice Address - Fax:480-659-1525
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036095527208600000X
AZ55626208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206147262OtherMEDICARE PTAN (INDIVIDUAL)
IL036095527Medicaid
IL206147OtherMEDICARE PTAN (GROUP)
AZ398525Medicaid