Provider Demographics
NPI:1780287284
Name:KUBAT, MEAGAN TRAVERS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MEAGAN
Middle Name:TRAVERS
Last Name:KUBAT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 MICHAEL CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3511
Mailing Address - Country:US
Mailing Address - Phone:757-619-6048
Mailing Address - Fax:
Practice Address - Street 1:1280 N GREAT NECK RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2126
Practice Address - Country:US
Practice Address - Phone:757-481-2678
Practice Address - Fax:757-481-3438
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210738183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist