Provider Demographics
NPI:1073897146
Name:MACDONALD, MEGAN S (PT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:S
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 N CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:DAGSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19939-9246
Mailing Address - Country:US
Mailing Address - Phone:302-858-2012
Mailing Address - Fax:
Practice Address - Street 1:29 ATLANTIC AVE
Practice Address - Street 2:SUITE N
Practice Address - City:OCEAN VIEW
Practice Address - State:DE
Practice Address - Zip Code:19970-9155
Practice Address - Country:US
Practice Address - Phone:302-541-5705
Practice Address - Fax:302-541-5706
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002046225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist