Provider Demographics
NPI:1609854272
Name:MORISHITA, MEGUMI M (MD, MPH, FACOG)
Entity Type:Individual
Prefix:DR
First Name:MEGUMI
Middle Name:M
Last Name:MORISHITA
Suffix:
Gender:F
Credentials:MD, MPH, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5579
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97708-5579
Mailing Address - Country:US
Mailing Address - Phone:541-706-5920
Mailing Address - Fax:541-706-5925
Practice Address - Street 1:2600 NE NEFF RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6337
Practice Address - Country:US
Practice Address - Phone:541-706-5920
Practice Address - Fax:541-706-5925
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD25973207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR269877Medicaid
OR269877Medicaid