MEDICARE: DR. MICHAEL J CORRIGAN 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
1	207R00000X	Internal Medicine Physician	42-0006830	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194793703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J CORRIGAN MD

Provider Business Mailing Address
First Line	:	PO BOX 1346
Second Line	:
City	:	WILLISTON
State	:	VT
Zip	:	05495-1346
Country	:	US
Telephone Number	:	802-527-1405
Fax Number	:	802-933-5702

Provider Business Practice Location Address
First Line	:	12 CHURCH ST
Second Line	:
City	:	SWANTON
State	:	VT
Zip	:	05488-1403
Country	:	US
Telephone Number	:	802-868-3175
Fax Number	:	802-868-2923

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	04/08/2009

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