Provider Demographics
NPI:1770650947
Name:MEGARA, JOSEPH ANTHONY III (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:MEGARA
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 GROVE AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08086-2557
Mailing Address - Country:US
Mailing Address - Phone:856-579-8674
Mailing Address - Fax:856-579-8676
Practice Address - Street 1:204 GROVE AVE
Practice Address - Street 2:SUITE G
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08086-2557
Practice Address - Country:US
Practice Address - Phone:856-579-8674
Practice Address - Fax:856-579-8676
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00273100213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1951002OtherCIGNA PROVIDER NUMBER
NJG3597421OtherOXFORD GROUP NUMBER
NJ273402206OtherGRUP TAX ID
NJ91001485801OtherAMERICHOICE GROUP NUMBER
NJP3597426OtherOXFORD INDIVIDUAL NUMBER
NJ0002046Medicaid
NJ2335837000OtherAMERIHEALTH NUMBER
NJ2K5088OtherTRICARE AND HEALTHNET
NJ240449YHLKOtherMEDICARE PTAN
NJ2335837000OtherAMERIHEALTH NUMBER