Provider Demographics
NPI:1114628930
Name:SPEICHER, MEAGHAN KATHLEEN (PA-C)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:KATHLEEN
Last Name:SPEICHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MEAGHAN
Other - Middle Name:KATHLEEN
Other - Last Name:SYLVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5408 JEFFERSON CIR S
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-2660
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5785 ROSWELL RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4903
Practice Address - Country:US
Practice Address - Phone:404-907-4820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant