Provider Demographics
NPI:1154325793
Name:MEGA, JOHN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:MEGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11137
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25339-1137
Mailing Address - Country:US
Mailing Address - Phone:304-344-3457
Mailing Address - Fax:304-344-3480
Practice Address - Street 1:1120 KANAWHA BLVD E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-2400
Practice Address - Country:US
Practice Address - Phone:304-344-3457
Practice Address - Fax:304-344-3480
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV181712085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVG14623OtherBRICKSTREET INSURANCE
WV0120703000Medicaid
WV0130753OtherUMWA
OH0171077Medicaid
WV14193OtherCARELINK & CARELINK PEIA
WV14175Medicaid
KY64942006Medicaid
WVG14623OtherBRICKSTREET INSURANCE
KY64942006Medicaid