Provider Demographics
NPI:1063850428
Name:MCAULIFFE, MEGAN
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:
Last Name:MCAULIFFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 PARK POINTE WAY
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-4054
Mailing Address - Country:US
Mailing Address - Phone:443-794-2266
Mailing Address - Fax:
Practice Address - Street 1:689 LAKE DR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21158-1444
Practice Address - Country:US
Practice Address - Phone:443-794-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE71339163W00000X
WV71339207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No163W00000XNursing Service ProvidersRegistered Nurse