Provider Demographics
NPI:1689158982
Name:SYLVESTER, MAEGAN GRIGGS (PHD)
Entity Type:Individual
Prefix:DR
First Name:MAEGAN
Middle Name:GRIGGS
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 BLACK HAWK LN
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-6800
Mailing Address - Country:US
Mailing Address - Phone:318-372-2522
Mailing Address - Fax:
Practice Address - Street 1:1311 HAZEL ST
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:LA
Practice Address - Zip Code:71001-4113
Practice Address - Country:US
Practice Address - Phone:318-263-9160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist