Provider Demographics
NPI:1558524074
Name:JORDAN, MEGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:JORDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2424 ERWIN RD
Mailing Address - Street 2:HOCK PLAZA SUITE 602 ROOM 6054
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3824
Mailing Address - Country:US
Mailing Address - Phone:734-255-8365
Mailing Address - Fax:
Practice Address - Street 1:2424 ERWIN RD
Practice Address - Street 2:HOCK PLAZA SUITE 602 ROOM 6054
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3824
Practice Address - Country:US
Practice Address - Phone:734-255-8365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-01117207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine