Provider Demographics
NPI:1114395142
Name:HART, MEGAN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:HART
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 1:34055 SOLON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2662
Mailing Address - Country:US
Mailing Address - Phone:440-914-7840
Mailing Address - Fax:
Practice Address - Street 1:34055 SOLON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2662
Practice Address - Country:US
Practice Address - Phone:440-914-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6907133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric