Provider Demographics
NPI:1275108052
Name:AZADIAN, MEGAN (PA-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:AZADIAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MA
Mailing Address - Zip Code:01929-1117
Mailing Address - Country:US
Mailing Address - Phone:978-380-0589
Mailing Address - Fax:
Practice Address - Street 1:97 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MA
Practice Address - Zip Code:01929-1117
Practice Address - Country:US
Practice Address - Phone:978-380-0589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant