Provider Demographics
NPI:1124408638
Name:EBEL, MEGAN ANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ANNE
Last Name:EBEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5802 E VIRGINIA BEACH BLVD
Mailing Address - Street 2:STE 107
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2475
Mailing Address - Country:US
Mailing Address - Phone:757-217-2050
Mailing Address - Fax:
Practice Address - Street 1:5802 E VIRGINIA BEACH BLVD
Practice Address - Street 2:STE 107
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2475
Practice Address - Country:US
Practice Address - Phone:757-217-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002400152W00000X, 152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision