Provider Demographics
NPI:1144755661
Name:DETERMAN, MEGAN RENEE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:RENEE
Last Name:DETERMAN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2976
Mailing Address - Country:US
Mailing Address - Phone:908-604-7800
Mailing Address - Fax:
Practice Address - Street 1:140 ALLEN RD
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-2976
Practice Address - Country:US
Practice Address - Phone:908-604-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11161700207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology