Provider Demographics
NPI:1952740219
Name:SMITH, MEAGAN SHERIDAN
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:SHERIDAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 PUTNAM AVE
Mailing Address - Street 2:APT. #2
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-2943
Mailing Address - Country:US
Mailing Address - Phone:617-955-3494
Mailing Address - Fax:
Practice Address - Street 1:29 PUTNAM AVE
Practice Address - Street 2:APT. #2
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-2943
Practice Address - Country:US
Practice Address - Phone:617-955-3494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist