Healthcare Provider Details

I. General information

NPI: 1851358493
Provider Name (Legal Business Name): MEGAN B WOERTH DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106 SILVERSIDE RD SUITE 102
WILMINGTON DE
19810-4162
US

IV. Provider business mailing address

12 PALMER DR
GLEN MILLS PA
19342-1288
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-8099
  • Fax:
Mailing address:
  • Phone: 610-358-5907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE10001000
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: