Provider Demographics
NPI:1073562377
Name:BARRUS, MEGHAN MICHELLE (PA)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:MICHELLE
Last Name:BARRUS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:MICHELLE
Other - Last Name:BEAUCHAMP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:3600 W BETHEL AVE
Mailing Address - Street 2:CENTRAL INDIANA ORTHOPEDICS, PC
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5407
Mailing Address - Country:US
Mailing Address - Phone:765-284-7738
Mailing Address - Fax:765-284-4266
Practice Address - Street 1:3600 W BETHEL AVE
Practice Address - Street 2:CENTRAL INDIANA ORTHOPEDICS, PC
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5407
Practice Address - Country:US
Practice Address - Phone:765-284-7738
Practice Address - Fax:765-284-4266
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601004627363A00000X
IN10000947A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
INQ61551Medicare UPIN
IN058940BBBBMedicare PIN