Provider Demographics
NPI:1144454695
Name:STEVENSON, MEGAN A (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:A
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 2ND AVE
Mailing Address - Street 2:APT 2A
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1414
Mailing Address - Country:US
Mailing Address - Phone:513-313-4215
Mailing Address - Fax:
Practice Address - Street 1:231 ALBERT SABIN WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-2827
Practice Address - Country:US
Practice Address - Phone:513-558-5861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.121751208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery