Provider Demographics
NPI:1508194143
Name:DOLAN, MEGHAN (PA-C)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:DOLAN
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 1:3 SAINT FRANCIS WAY STE 206
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5121
Mailing Address - Country:US
Mailing Address - Phone:724-772-5115
Mailing Address - Fax:724-772-5337
Practice Address - Street 1:3 SAINT FRANCIS WAY STE 206
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-5121
Practice Address - Country:US
Practice Address - Phone:724-772-5115
Practice Address - Fax:724-772-5337
Is Sole Proprietor?:No
Enumeration Date:2009-11-19
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054142363AS0400X
CT2861363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical