Provider Demographics
NPI:1407054257
Name:RODDEN, MEGHAN FUSZ (MD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:FUSZ
Last Name:RODDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:SUSANNE
Other - Last Name:FUSZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8262 ATLEE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-1816
Mailing Address - Country:US
Mailing Address - Phone:804-325-8720
Mailing Address - Fax:804-764-7351
Practice Address - Street 1:8262 ATLEE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-1816
Practice Address - Country:US
Practice Address - Phone:804-325-8720
Practice Address - Fax:804-764-7351
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070191222084N0400X
VA01012528442084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06115OtherGROUP PTAN