Provider Demographics
NPI:1134354012
Name:HEIL, MEGAN NICHOLE (DO)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:NICHOLE
Last Name:HEIL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:NICHOLE
Other - Last Name:BRIDGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:8084 E QUIET HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:IN
Mailing Address - Zip Code:46567-7522
Mailing Address - Country:US
Mailing Address - Phone:573-712-8929
Mailing Address - Fax:
Practice Address - Street 1:1615 WINSTED DR
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-4696
Practice Address - Country:US
Practice Address - Phone:574-533-8633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02004590A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology