Provider Demographics
NPI:1851358493
Name:WOERTH, MEGAN B (DPM)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:B
Last Name:WOERTH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 PALMER DR
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1288
Mailing Address - Country:US
Mailing Address - Phone:610-358-5907
Mailing Address - Fax:
Practice Address - Street 1:2106 SILVERSIDE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4162
Practice Address - Country:US
Practice Address - Phone:302-478-8099
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEE10001000213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000406517Medicaid
DE014435B49Medicare ID - Type Unspecified
DE0000406517Medicaid