Provider Demographics
NPI:1942640297
Name:PRZYBROWSKI, MEGAN DIANE (PA)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:DIANE
Last Name:PRZYBROWSKI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:DIANE
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:867 BLUE GOOSE RD
Mailing Address - Street 2:
Mailing Address - City:FRIENDSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21531-1256
Mailing Address - Country:US
Mailing Address - Phone:814-939-9012
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-1200
Practice Address - Country:US
Practice Address - Phone:304-598-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC05295207P00000X
MDC0005295363A00000X
VA0110-004282363A00000X
WV2159363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MM2942109Medicare UPIN