Organization
MATTHEW MORGAN TIGNOR MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW M TIGNOR SR. MD (PRESIDENT)
(757) 491-3130
Entity
Organization
Contact information
Practice address
1064 LASKIN RD, 14, VIRGINIA BEACH, VA 23451-6337
(757) 491-3130
(757) 491-3512
Mailing address
1064 LASKIN RD, 14, VIRGINIA BEACH, VA 23451-6337
(757) 491-3130
(757) 491-3512
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
0101029409
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006099181
—
VA
01
—
029575
BC/BS
—
01
—
110015831
RAILROAD MEDICARE
—
01
—
17970
OPTIMA
—
01
—
220771
MDIPA
—
01
—
227640557
CHAMPUS
—
01
—
890579E
MEDICAID NC
NC
Enumeration date
11/28/2007
Last updated
06/29/2010
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