Provider Demographics
NPI:1497961155
Name:CARIGNAN, MARTIN J (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:J
Last Name:CARIGNAN
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 1:14330 OAKHILL PARK LN STE 125
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-3481
Mailing Address - Country:US
Mailing Address - Phone:704-659-4499
Mailing Address - Fax:800-878-1090
Practice Address - Street 1:14330 OAKHILL PARK LN STE 125
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3481
Practice Address - Country:US
Practice Address - Phone:704-659-4499
Practice Address - Fax:800-878-1090
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL27352086S0129X
NC2013-001332086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1512759Medicaid
TN4225350OtherBCBS
CA1497961155Medicaid
TN30414341Medicare PIN
CAWA73387AMedicare PIN
TN3041434Medicare PIN