Healthcare Provider Details

I. General information

NPI: 1821380007
Provider Name (Legal Business Name): MEGAN OBERLE BENSIGNOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 S 7TH ST
MINNEAPOLIS MN
55454-1404
US

IV. Provider business mailing address

3401 CIVIC CENTER BLVD DEPARTMENT OF ENDOCRINOLOGY
PHILADELPHIA PA
19104
US

V. Phone/Fax

Practice location:
  • Phone: 612-365-6777
  • Fax: 612-365-8001
Mailing address:
  • Phone: 216-536-5905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberMT205591
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number62192
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: