Provider Demographics
NPI:1770068470
Name:DAVIES, MEGAN MARIA (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIA
Last Name:DAVIES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4416 WINGATE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6066
Mailing Address - Country:US
Mailing Address - Phone:919-703-8631
Mailing Address - Fax:
Practice Address - Street 1:1390 CAPITAL BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1118
Practice Address - Country:US
Practice Address - Phone:919-836-1642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36095207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1OtherDO NOT HAVE ANY SUCH NUMBERS