Provider Demographics
NPI:1598461691
Name:DIXON, MEGHAN MADISON (PA)
Entity Type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:MADISON
Last Name:DIXON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1300 HOSPITAL DR STE 120
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3204
Mailing Address - Country:US
Mailing Address - Phone:843-849-8418
Mailing Address - Fax:843-849-8419
Practice Address - Street 1:1300 HOSPITAL DR STE 120
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3204
Practice Address - Country:US
Practice Address - Phone:843-849-8418
Practice Address - Fax:843-849-8419
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMPA.4753363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical