Provider Demographics
NPI:1164646683
Name:WOMACK, MEGHAN E (MD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:E
Last Name:WOMACK
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:PO BOX 747
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-0747
Mailing Address - Country:US
Mailing Address - Phone:800-345-0045
Mailing Address - Fax:973-740-1350
Practice Address - Street 1:750 BRUNSWICK AVE
Practice Address - Street 2:HELENE FULD MEDICAL CENTER
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-4143
Practice Address - Country:US
Practice Address - Phone:609-394-6000
Practice Address - Fax:973-740-1350
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08210400207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine