Basic Information
| Provider Information | |||||||||
| NPI: | 1649255126 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZIEGLER | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WORSHAM | ||||||||
| OtherFirstName: | ANNE | ||||||||
| OtherMiddleName: | E | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 202 MAPLEWOOD AVENUE | ||||||||
| Address2: | ATTN: ANESTHESIA | ||||||||
| City: | RONCEVERTE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 249701334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046474411 | ||||||||
| FaxNumber: | 3046476076 | ||||||||
| Practice Location | |||||||||
| Address1: | 202 MAPLEWOOD AVE | ||||||||
| Address2: | ATTN: ANESTHESIA | ||||||||
| City: | RONCEVERTE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 249701334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046474411 | ||||||||
| FaxNumber: | 3046476076 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2005 | ||||||||
| LastUpdateDate: | 08/14/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD051704L | PA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 26190 | WV | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.