Provider Demographics
NPI:1861451460
Name:BERRIGAN, MICHAEL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
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 1:900 23RD ST NW
Mailing Address - Street 2:SUITE G - 2092
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2342
Mailing Address - Country:US
Mailing Address - Phone:202-715-4750
Mailing Address - Fax:
Practice Address - Street 1:900 23RD ST. N.W., SUITE G - 2092
Practice Address - Street 2:GEORGE WASHINGTON UNIVERSITY HOSPITAL
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-715-4752
Practice Address - Fax:202-715-4759
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD18155207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC027203200Medicaid
F05810Medicare UPIN
002214G49Medicare PIN
DC027203200Medicaid