Healthcare Provider Details

I. General information

NPI: 1639406432
Provider Name (Legal Business Name): MEGHAN M. WATTS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. MEGHAN MANGRELLI DUNN

II. Dates (important events)

Enumeration Date: 11/16/2009
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD CHRISTIANA HOSPITAL EMERGENCY DEPARTMENT
NEWARK DE
19718-2200
US

IV. Provider business mailing address

34052 GREENFIELD CT
LEWES DE
19958-7317
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-1000
  • Fax:
Mailing address:
  • Phone: 302-740-8678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberC5-0000688
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: