Healthcare Provider Details

I. General information

NPI: 1790983393
Provider Name (Legal Business Name): MEGAN NAKASHIMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 05/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE L-25
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE L-25
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-1860
  • Fax:
Mailing address:
  • Phone: 216-444-1860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD441669
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberMT190378
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: