Provider Demographics
NPI:1548359821
Name:TIGANI, MICHAEL CARMINE (MD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:CARMINE
Last Name:TIGANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2002 MEDICAL PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7901
Mailing Address - Country:US
Mailing Address - Phone:410-571-8733
Mailing Address - Fax:410-571-6309
Practice Address - Street 1:6845 ELM ST
Practice Address - Street 2:SUITE 250
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-6007
Practice Address - Country:US
Practice Address - Phone:703-356-5484
Practice Address - Fax:703-356-2223
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD16595207W00000X
MDD0034058207W00000X
VA0101040992207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA121139M51Medicare PIN
B93507Medicare UPIN