Healthcare Provider Details

I. General information

NPI: 1619645439
Provider Name (Legal Business Name): MEGAN BAUDER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2021
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 W ORANGE GROVE RD
TUCSON AZ
85741-3118
US

IV. Provider business mailing address

5055 E BROADWAY BLVD STE A100
TUCSON AZ
85711-3629
US

V. Phone/Fax

Practice location:
  • Phone: 520-742-0414
  • Fax: 520-742-6635
Mailing address:
  • Phone: 520-327-0460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: