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NPI Code Detail

MEDICARE: MEGAN MATT PA

MEDICARE: MEGAN MATT PA
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
1363A00000XPhysician AssistantOH

Other Identifiers

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

General Provider Information

NPI Number : 1306510474
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN MATT PA
Provider Business Mailing Address
First Line : 1975 MIAMISBURG CENTERVILLE RD
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-3811
Country : US
Telephone Number : 937-439-6186
Fax Number : 937-353-7219
Provider Business Practice Location Address
First Line : 3535 SOUTHERN BLVD
Second Line :
City : KETTERING
State : OH
Zip : 45429-1221
Country : US
Telephone Number : 937-395-8166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2021
Last Update Date : 02/27/2026

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Directions to “ MEGAN MATT PA” Practice Location

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