Healthcare Provider Details

I. General information

NPI: 1760305734
Provider Name (Legal Business Name): MEGAN TETER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4420 LAKE BOONE TRL STE 203
RALEIGH NC
27607-7505
US

IV. Provider business mailing address

251 DANIEL RIDGE RD
WENDELL NC
27591-6011
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-2930
  • Fax:
Mailing address:
  • Phone: 330-808-7690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number0010-16782
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16782
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: