Healthcare Provider Details

I. General information

NPI: 1033831789
Provider Name (Legal Business Name): MEGAN NICOLE MCCLARY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 09/19/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 WAGNER RD
MONACA PA
15061-2329
US

IV. Provider business mailing address

376 PINEHAVEN DR
BETHEL PARK PA
15102-1142
US

V. Phone/Fax

Practice location:
  • Phone: 724-671-1500
  • Fax:
Mailing address:
  • Phone: 412-874-4587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMA063948
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: