Provider Demographics
NPI:1992020549
Name:STIGALL, REBECCA ERIN (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ERIN
Last Name:STIGALL
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:FOUR TOWER BRIDGE, 200 BARR HARBOR DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEST CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428
Mailing Address - Country:US
Mailing Address - Phone:502-271-9623
Mailing Address - Fax:848-240-2812
Practice Address - Street 1:1099 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7346
Practice Address - Country:US
Practice Address - Phone:800-337-6663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT200387207N00000X
TNMD50939207N00000X
NC2017-00657207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology