Healthcare Provider Details

I. General information

NPI: 1346243557
Provider Name (Legal Business Name): MICHAEL J CORRIGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 STATE RD
NORTH DARTMOUTH MA
02747-3322
US

IV. Provider business mailing address

49 STATE RD
NORTH DARTMOUTH MA
02747-3322
US

V. Phone/Fax

Practice location:
  • Phone: 508-993-7344
  • Fax: 508-990-2072
Mailing address:
  • Phone: 508-993-7344
  • Fax: 508-990-2072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number47516
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: