Provider Demographics
NPI:1114066867
Name:VIGLIANO, MEGAN LOUISE (MEGAN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LOUISE
Last Name:VIGLIANO
Suffix:
Gender:F
Credentials:MEGAN
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:PLATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MEGAN
Mailing Address - Street 1:1202 MEDICAL CENTER DR
Mailing Address - Street 2:WILMINGTON HEALTH, PLLC
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7307
Mailing Address - Country:US
Mailing Address - Phone:910-341-3300
Mailing Address - Fax:910-251-8824
Practice Address - Street 1:1124 GALLERY PARK BOULEVARD
Practice Address - Street 2:#200
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412
Practice Address - Country:US
Practice Address - Phone:910-341-3300
Practice Address - Fax:910-251-2067
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00853363AM0700X
PAMA052822363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant