Healthcare Provider Details

I. General information

NPI: 1154334167
Provider Name (Legal Business Name): MEGAN E APP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1430
PORTAGE IN
46368-9230
US

IV. Provider business mailing address

18715 OLDFIELD RD
NEW BUFFALO MI
49117-8879
US

V. Phone/Fax

Practice location:
  • Phone: 219-764-5356
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036-100761
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: