Provider Demographics
NPI:1316083629
Name:CAREY M VIGOR MD PC
Entity type:Organization
Organization Name:CAREY M VIGOR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VIGOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-615-4323
Mailing Address - Street 1:18530 MACK AVE # 478
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-3254
Mailing Address - Country:US
Mailing Address - Phone:586-615-4323
Mailing Address - Fax:586-778-1342
Practice Address - Street 1:824 CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:TN
Practice Address - Zip Code:38255-3000
Practice Address - Country:US
Practice Address - Phone:586-615-4323
Practice Address - Fax:586-778-1342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN418852084N0400X, 2084N0600X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Not Answered2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
Not Answered2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty