Healthcare Provider Details

I. General information

NPI: 1801885397
Provider Name (Legal Business Name): TOM ADOLPH CORRIGAN D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 06/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15810 DETROIT AVE
LAKEWOOD OH
44107-3711
US

IV. Provider business mailing address

15810 DETROIT AVE
LAKEWOOD OH
44107-3711
US

V. Phone/Fax

Practice location:
  • Phone: 216-529-1800
  • Fax: 216-529-3201
Mailing address:
  • Phone: 216-529-1800
  • Fax: 216-529-3201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number36-00-3355-C
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: