Provider Demographics
NPI:1457447054
Name:YUNGHANS, MEGAN K (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:K
Last Name:YUNGHANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:YUNGHANS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 749112
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9112
Mailing Address - Country:US
Mailing Address - Phone:434-295-1000
Mailing Address - Fax:
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-1891
Practice Address - Country:US
Practice Address - Phone:434-924-5321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101256244208000000X
CAC162018208000000X
MO2018027245208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09463OtherGROUP PTAN