Provider Demographics
NPI:1780846261
Name:MURPHY, MEGHAN K (DO)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:K
Last Name:MURPHY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MEGHAN
Other - Middle Name:KOELSCH
Other - Last Name:STEEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:42 NORTH ST. JOSEPH AVE.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-2208
Mailing Address - Country:US
Mailing Address - Phone:269-687-0808
Mailing Address - Fax:269-687-0811
Practice Address - Street 1:42 NORTH ST. JOSEPH AVE.
Practice Address - Street 2:SUITE 201
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-2208
Practice Address - Country:US
Practice Address - Phone:269-687-0808
Practice Address - Fax:269-687-0811
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017723207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1780846261Medicaid
MIMI2051193Medicare PIN