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NPI Code Detail

MEDICARE: MEGAN E FONDREN PA-C

MEDICARE: MEGAN E FONDREN PA-C
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 Assistant5601006098MI

General Provider Information

NPI Number : 1528347317
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN E FONDREN PA-C
Provider Business Mailing Address
First Line : 190 E STATE ST
Second Line :
City : MONTROSE
State : MI
Zip : 48457-9144
Country : US
Telephone Number : 810-639-2056
Fax Number : 810-639-3167
Provider Business Practice Location Address
First Line : 190 E STATE ST
Second Line :
City : MONTROSE
State : MI
Zip : 48457-9144
Country : US
Telephone Number : 810-639-2056
Fax Number : 810-639-3167
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2011
Last Update Date : 03/17/2025

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Directions to “ MEGAN E FONDREN PA-C” Practice Location

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