Provider Demographics
NPI:1922026269
Name:SIGMON, RICHARD L JR (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:SIGMON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 N KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-3055
Mailing Address - Country:US
Mailing Address - Phone:843-492-2751
Mailing Address - Fax:843-839-0275
Practice Address - Street 1:7900 N KINGS HWY
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-3055
Practice Address - Country:US
Practice Address - Phone:843-492-2751
Practice Address - Fax:843-839-0275
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24616207R00000X, 207RG0100X
SC94015207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1922026269Medicaid
SCN24616Medicaid
NC8976172Medicaid
NC1922026269Medicaid
NCNCT287AMedicare PIN
NCC86450Medicare UPIN
SCN24616Medicaid
NC210426KMedicare PIN