Provider Demographics
NPI:1477147726
Name:DEWITT, MEGAN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:DEWITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 PRITT LN
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:WV
Mailing Address - Zip Code:26253-4704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:132 PRITT LN
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:WV
Practice Address - Zip Code:26253-4704
Practice Address - Country:US
Practice Address - Phone:681-298-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-26
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No172V00000XOther Service ProvidersCommunity Health Worker