Healthcare Provider Details

I. General information

NPI: 1508788142
Provider Name (Legal Business Name): MATTHEW MEGILL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL OF HOPE BP 10
MANGO SAVANES
BP 10
TG

IV. Provider business mailing address

19 MAPLE ST
PRINCETON NJ
08542-3850
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone: 609-365-0110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD435822
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: