Doctor Name: | MAEGAN E GREENWADE |
NPI Number: | 1003128547 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | OA003405 |
Business Practice Address: | 4200 Union Deposit Rd Harrisburg, PA - 171112801 |
Business Phone Number: | 7175586708 |
Business Fax Number: | |
Mailing Address: | 2412 Aspen Way, HARRISBURG |
State: | PA |
Postal Code: | 171109289 |
Phone Number: | 5702950944 |
Fax Number: | |
NPI Enumeration Date: | 07/13/2010 |
NPI Last Update Date: | 04/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | OA003405 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |