Provider Demographics
NPI:1942697263
Name:DISHER, MEGAN (PA-C)
Entity Type:Individual
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First Name:MEGAN
Middle Name:
Last Name:DISHER
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:151 SOUTHHALL LANE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:407-650-3455
Practice Address - Street 1:2100 EMMANUEL WAY
Practice Address - Street 2:SUITE D
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45502-7217
Practice Address - Country:US
Practice Address - Phone:937-325-6711
Practice Address - Fax:937-439-7443
Is Sole Proprietor?:No
Enumeration Date:2015-04-24
Last Update Date:2015-06-23
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Provider Licenses
StateLicense IDTaxonomies
OH004252363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant