Healthcare Provider Details

I. General information

NPI: 1770922577
Provider Name (Legal Business Name): MEGHAN MINNOCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2013
Last Update Date: 05/24/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 FREEPORT RD STE 120 SUITE 120
BLAWNOX PA
15238-3485
US

IV. Provider business mailing address

2 HOT METAL ST QUANTUM ONE SUITE 001
PITTSBURGH PA
15203-2348
US

V. Phone/Fax

Practice location:
  • Phone: 412-782-4340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS018757
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: