Provider Demographics
NPI:1376703538
Name:MCGANN, NATALIE E (DO)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:E
Last Name:MCGANN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 TELFORD PIKE
Mailing Address - Street 2:
Mailing Address - City:TELFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18969-2251
Mailing Address - Country:US
Mailing Address - Phone:215-723-7833
Mailing Address - Fax:
Practice Address - Street 1:211 TELFORD PIKE
Practice Address - Street 2:
Practice Address - City:TELFORD
Practice Address - State:PA
Practice Address - Zip Code:18969-2251
Practice Address - Country:US
Practice Address - Phone:215-723-7833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102434577 0001Medicaid
PA182197JDBOtherMEDICARE