Healthcare Provider Details

I. General information

NPI: 1063942340
Provider Name (Legal Business Name): MEGAN ELIZABETH PSIONES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGAN ELIZABETH GRAETER MD

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2051 CLEVIDENCE BLVD STE C
CLARKSVILLE IN
47129-2278
US

IV. Provider business mailing address

86 W UNDERWOOD ST STE 202
ORLANDO FL
32806-1110
US

V. Phone/Fax

Practice location:
  • Phone: 812-280-6623
  • Fax: 812-666-7688
Mailing address:
  • Phone: 407-649-6876
  • Fax: 407-872-0544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01084229A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: