Healthcare Provider Details

I. General information

NPI: 1003947664
Provider Name (Legal Business Name): MICHAEL J CORRIGAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 01/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 CHURCH ST
SWANTON VT
05488-1403
US

IV. Provider business mailing address

67 SHAWVILLE RD
SHELDON VT
05483-8383
US

V. Phone/Fax

Practice location:
  • Phone: 802-868-3175
  • Fax: 802-868-2923
Mailing address:
  • Phone: 802-933-5702
  • Fax: 802-933-5702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL J CORRIGAN
Title or Position: PHYSICIAN OWNER
Credential: M.D.
Phone: 802-868-3175