Provider Demographics
NPI:1376765784
Name:MEUSE, MEGAN C (MD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:C
Last Name:MEUSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:200 PROVIDENCE RD
Mailing Address - Street 2:ST. 101
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1468
Mailing Address - Country:US
Mailing Address - Phone:704-749-5800
Mailing Address - Fax:704-749-5819
Practice Address - Street 1:200 HAWTHORNE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2515
Practice Address - Country:US
Practice Address - Phone:704-384-5145
Practice Address - Fax:704-749-5819
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101243438207L00000X
NC2010-00962207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC017276A76Medicare PIN