Doctor Name: | DR. MEGAN MAZZARELLA |
NPI Number: | 1063895415 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DMD |
License Number: | |
Business Practice Address: | 1851 Macgregor Downs Rd Ecu Mailstop 701 Greenville, NC - 278345925 |
Business Phone Number: | 2527377834 |
Business Fax Number: | 2527377853 |
Mailing Address: | 1851 Macgregor Downs Rd, Ecu Mailstop 701 GREENVILLE |
State: | NC |
Postal Code: | 278345925 |
Phone Number: | 2527377834 |
Fax Number: | 2527377853 |
NPI Enumeration Date: | 07/02/2015 |
NPI Last Update Date: | 07/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |