Mctigue, Mary Kathleen
Mctigue, Mary Kathleen is an individual health care provider with primary practice located at 1200 S Rogers St , Bloomington IN 47403-4792. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Mctigue, Mary Kathleen can be contacted via phone (812) 339-6434.Contact Information
Primary practice address
1200 S Rogers St
Bloomington IN 47403-4792
Phone: (812) 339-6434
Fax: (812) 331-0196
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 01039092A | Indiana |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 01039092A | Indiana |
Profile Details
| NPI number | 1578567343 |
|---|---|
| LBN Legal business name | Mctigue, Mary Kathleen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2005 |
| Last updated | May 19th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578567343 | NPPES |
| Indiana | MEDICAID | 100345180 |
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