Provider Demographics
NPI:1255914743
Name:CUNNINGHAM GRANDALSKI, MEGAN ELIZABETH (DO)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:CUNNINGHAM GRANDALSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 VILLAGE DR STE C
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3783
Mailing Address - Country:US
Mailing Address - Phone:724-834-2525
Mailing Address - Fax:724-834-6171
Practice Address - Street 1:200 VILLAGE DR STE C
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3783
Practice Address - Country:US
Practice Address - Phone:724-834-2525
Practice Address - Fax:724-834-6171
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOT020644207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine