Provider Demographics
NPI:1114933348
Name:BERRIGAN, THOMAS J (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:BERRIGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO DRAWER 7586
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29938-7586
Mailing Address - Country:US
Mailing Address - Phone:843-757-7227
Mailing Address - Fax:843-757-4996
Practice Address - Street 1:PO DRAWER 7586
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29938-7586
Practice Address - Country:US
Practice Address - Phone:843-757-7227
Practice Address - Fax:843-757-4996
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC75472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC075475Medicaid
B91397Medicare UPIN