Individual
DR. SOPHIA A SIBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
200 HEALTH CENTER DRIVE, UNION, WV 24983-0000
(304) 772-3064
(304) 772-3296
Mailing address
PO BOX 590, UNION, WV 24983-0590
(304) 772-3064
(304) 772-3296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2102
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001714321
BC/BS
WV
01
—
176557
ANTHEM BC/BS-UNION
WV
01
—
176558
PETERSTOWN
WV
05
—
3810001719
—
WV
01
—
5611053
AETNA
WV
01
—
8130658
MAMSI
WV
01
—
P00206497
RAILROAD MEDICARE
WV
01
—
VAA104451
GROUP PTAN
VA
Enumeration date
07/11/2005
Last updated
01/29/2025
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