Healthcare Provider Details

I. General information

NPI: 1710903117
Provider Name (Legal Business Name): MEGAN C. MACNEIL, MD, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 PARKSIDE DR STE 200
COLORADO SPRINGS CO
80910-3131
US

IV. Provider business mailing address

215 PARKSIDE DR STE 200
COLORADO SPRINGS CO
80910-3131
US

V. Phone/Fax

Practice location:
  • Phone: 719-475-9613
  • Fax:
Mailing address:
  • Phone: 719-475-9613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number44403
License Number StateCO

VIII. Authorized Official

Name: MEGAN CATHERINE MACNEIL
Title or Position: M.D.
Credential: M.D.
Phone: 719-475-9613