| Doctor Name: | MEGAN NORTHUP |
| NPI Number: | 1700125580 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 04-37199 |
| Business Practice Address: | Building 3224, Marine Corps Air Station Yuma Cannon Air Defenese Complex Medical Department Yuma, AZ - 85369 |
| Business Phone Number: | 9282693808 |
| Business Fax Number: | |
| Mailing Address: | Po Box 99210, Cannon Air Defenese Complex Medical Department YUMA |
| State: | AZ |
| Postal Code: | 853699210 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/13/2013 |
| NPI Last Update Date: | 08/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 04-37199 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |