Provider Demographics
NPI:1114698529
Name:PERRY, MEGAN ANDREWS
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANDREWS
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELISE
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:847 SOCIETY CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-2479
Mailing Address - Country:US
Mailing Address - Phone:770-630-8735
Mailing Address - Fax:
Practice Address - Street 1:847 SOCIETY CT
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-2479
Practice Address - Country:US
Practice Address - Phone:770-630-8735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant