Provider Demographics
NPI:1912141938
Name:TIGER, MICHAEL KENNETH (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:KENNETH
Last Name:TIGER
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 1:101 BODEN CIRCLE
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIA
Mailing Address - City:TRAVIS AFB
Mailing Address - State:CA
Mailing Address - Zip Code:94535
Mailing Address - Country:US
Mailing Address - Phone:707-673-3594
Mailing Address - Fax:
Practice Address - Street 1:101 BODEN CIRCLE
Practice Address - Street 2:DEPARTMENT OF ANESTHESIA
Practice Address - City:TRAVIS AFB
Practice Address - State:CA
Practice Address - Zip Code:94535
Practice Address - Country:US
Practice Address - Phone:707-673-3594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA130537207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology