Provider Demographics
NPI:1508334004
Name:MOLNAR, MEGAN OLIVIA
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:OLIVIA
Last Name:MOLNAR
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 1:146 GROSVENOR ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-1716
Mailing Address - Country:US
Mailing Address - Phone:440-283-6903
Mailing Address - Fax:
Practice Address - Street 1:146 GROSVENOR ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1716
Practice Address - Country:US
Practice Address - Phone:440-283-6903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH175T00000XMedicaid