Provider Demographics
NPI:1891191904
Name:SMITH, MEGAN E (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:E
Last Name:SMITH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 W WARD RD STE 203
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-3047
Mailing Address - Country:US
Mailing Address - Phone:410-286-7205
Mailing Address - Fax:410-286-7206
Practice Address - Street 1:3140 W WARD RD STE 203
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-3047
Practice Address - Country:US
Practice Address - Phone:410-286-7205
Practice Address - Fax:410-286-7206
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305209148225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist