Provider Demographics
NPI:1265885602
Name:BOHRER, MEGAN ELIZABETH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:BOHRER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:GREENAWALT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2111 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2138
Mailing Address - Country:US
Mailing Address - Phone:740-566-4621
Mailing Address - Fax:740-566-4622
Practice Address - Street 1:80 STAR DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-9583
Practice Address - Country:US
Practice Address - Phone:740-672-2160
Practice Address - Fax:740-672-2161
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004669RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0182739Medicaid