Provider Demographics
NPI:1710137096
Name:ESHBAUGH, MEGAN ELIZABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:ESHBAUGH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:LAVORGNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1033 CHAMPIONS WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3777
Mailing Address - Country:US
Mailing Address - Phone:757-483-2786
Mailing Address - Fax:757-483-6325
Practice Address - Street 1:1033 CHAMPIONS WAY STE 100
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3777
Practice Address - Country:US
Practice Address - Phone:757-483-2786
Practice Address - Fax:757-483-6325
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
VA0102203395207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1710137096OtherNPI