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NPI Code Detail

MEDICARE: MATTHEW MORGAN TIGNOR MD

MEDICARE: MATTHEW MORGAN TIGNOR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0200XInfectious Disease Physician0101029409VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4110015831OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1227640557OTHERCHAMPUS
2220771OTHERMDIPA
3029575OTHERBC/BS
517970OTHEROPTIMA
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538341854
Entity Type Code : Organization
Provider Name (Legal Business Name) : MATTHEW MORGAN TIGNOR MD
Provider Business Mailing Address
First Line : 1064 LASKIN RD
Second Line : 14
City : VIRGINIA BEACH
State : VA
Zip : 23451-6337
Country : US
Telephone Number : 757-491-3130
Fax Number : 757-491-3512
Provider Business Practice Location Address
First Line : 1064 LASKIN RD
Second Line : 14
City : VIRGINIA BEACH
State : VA
Zip : 23451-6337
Country : US
Telephone Number : 757-491-3130
Fax Number : 757-491-3512
Authorized Official
Title or Position : PRESIDENT
Name : MATTHEW M TIGNOR SR.
Credential : MD
Telephone Number : 757-491-3130
Provider Enumeration Date : 11/28/2007
Last Update Date : 06/29/2010

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