Healthcare Provider Details

I. General information

NPI: 1396190641
Provider Name (Legal Business Name): KAYLA BERIGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2016
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 SIXTH ST
TRAVERSE CITY MI
49684-2345
US

IV. Provider business mailing address

PO BOX 30516 DEPT # 9516
LANSING MI
48909-8016
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-0497
  • Fax: 231-935-0498
Mailing address:
  • Phone: 231-935-0497
  • Fax: 231-935-0498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4301513824
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: