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Contact Information

MARY K MCTIGUE, MD
1200 S ROGERS ST
BLOOMINGTON, IN47403-4792
 Phone: 812-339-6434
 Fax: 812-331-0196
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for MARY K MCTIGUE · (Female)

NPI Number 1578567343
Status Active
Credentials MD
Entity Individual
Enumeration date 06/09/2005
Last updated 05/19/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01039092A
  • IN Medicaid 100345180
Hospital affiliation(s)
  • INDIANA UNIVERSITY HEALTH BLOOMINGTON HOSPITAL - (Acute Care)
    601 W SECOND ST
    BLOOMINGTON, IN 47403
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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