Provider Demographics
NPI:1588835524
Name:OSBORNE, MEGAN RAE (OD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:RAE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7615 COLONY RD
Mailing Address - Street 2:STE 105
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226
Mailing Address - Country:US
Mailing Address - Phone:704-543-9000
Mailing Address - Fax:704-543-9002
Practice Address - Street 1:7615 COLONY RD
Practice Address - Street 2:STE 105
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226
Practice Address - Country:US
Practice Address - Phone:704-543-9000
Practice Address - Fax:704-543-9002
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2069152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist