Provider Demographics
NPI:1023229143
Name:MEGAHED, MONA (MD)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:MEGAHED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 ABBEY CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-6017
Mailing Address - Country:US
Mailing Address - Phone:770-475-9924
Mailing Address - Fax:770-475-9438
Practice Address - Street 1:1800 ABBEY CT
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-6017
Practice Address - Country:US
Practice Address - Phone:770-475-9924
Practice Address - Fax:770-475-9438
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA059558208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003132548AMedicaid