Healthcare Provider Details

I. General information

NPI: 1255953840
Provider Name (Legal Business Name): MEGHAN DIER PA-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS MEGHAN MARIE WILLIAMS

II. Dates (important events)

Enumeration Date: 05/18/2020
Last Update Date: 11/03/2023
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 N REYNOLDS RD BLDG A
TOLEDO OH
43615-2100
US

IV. Provider business mailing address

333 N SUMMIT ST FL 7
TOLEDO OH
43604-1531
US

V. Phone/Fax

Practice location:
  • Phone: 419-578-7200
  • Fax: 419-537-5600
Mailing address:
  • Phone: 419-578-7200
  • Fax: 419-537-5600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.006636RX
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: