Provider Demographics
NPI:1477109791
Name:FERRON, MEGAN DENARAH (PA-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:DENARAH
Last Name:FERRON
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 1:4000 MITCHELLVILLE RD STE B322
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3176
Mailing Address - Country:US
Mailing Address - Phone:301-860-0305
Mailing Address - Fax:
Practice Address - Street 1:4000 MITCHELLVILLE RD STE B322
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3176
Practice Address - Country:US
Practice Address - Phone:301-860-0305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0007280208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine