Provider Demographics
NPI:1346322930
Name:SHIREY, MEGAN E (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:E
Last Name:SHIREY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:E
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:610-372-8044
Mailing Address - Fax:484-334-7026
Practice Address - Street 1:301 S 7TH AVE
Practice Address - Street 2:SUITE 245
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1410
Practice Address - Country:US
Practice Address - Phone:610-374-2214
Practice Address - Fax:610-374-5852
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA050807363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP58427Medicare UPIN
PA057364Medicare PIN