Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MED-RES-LIC-42280 | MT |
N | 111NI0900X | Internist | MED-RES-LIC-42280 | MT |
Y | 207RA0401X | Internist - Addiction Medicine | A165043 | CA |
NPI | 1508253634 |
---|---|
Provider Name | Christopher Kerrigan |
First Address | Ventura, CA 93003-7672 |
Second Address | Billings, MT 59101-0905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2015 |
Last Update Date | 16/11/2020 |