Provider Demographics
NPI:1245538990
Name:WELCH, MEGAN S (PA-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:S
Last Name:WELCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16 PELHAM RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2826
Mailing Address - Country:US
Mailing Address - Phone:603-898-2244
Mailing Address - Fax:603-898-2227
Practice Address - Street 1:16 PELHAM RD STE 1
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079
Practice Address - Country:US
Practice Address - Phone:603-898-2244
Practice Address - Fax:603-898-2227
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH0819363AS0400X
MAPA4494363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30338774Medicaid
NH30338774Medicaid