Provider Demographics
NPI:1174834766
Name:MCGREEVY, MEGAN MAUREEN (D O)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MAUREEN
Last Name:MCGREEVY
Suffix:
Gender:F
Credentials:D O
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MAUREEN
Other - Last Name:LAVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:D O
Mailing Address - Street 1:1000 HARRINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2920
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 HARRINGTON ST
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043
Practice Address - Country:US
Practice Address - Phone:586-493-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018812207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine