Individual
MATTHEW GIEGENGACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-7994
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-7994
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2007-01271
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437167350
—
VA
01
—
146GE
BCBS
—
01
—
202031
MEDCOST
—
05
—
3810010056
—
WV
05
—
5907662
—
NC
01
—
7387814
AETNA
—
01
—
810583
PARTNERS
—
05
—
Q0127B
—
SC
Enumeration date
08/04/2006
Last updated
08/23/2010
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