MEDICARE: MONA MEGAHED M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	059558	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023229143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONA MEGAHED M.D.

Provider Business Mailing Address
First Line	:	1800 ABBEY CT
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-6017
Country	:	US
Telephone Number	:	770-475-9924
Fax Number	:	770-475-9438

Provider Business Practice Location Address
First Line	:	1800 ABBEY CT
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-6017
Country	:	US
Telephone Number	:	770-475-9924
Fax Number	:	770-475-9438

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	04/26/2017

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