Healthcare Provider Details

I. General information

NPI: 1013446012
Provider Name (Legal Business Name): MEGAN ELIZABETH HOHENBERGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 SMITHFIELD WAY STE 101
FORT MILL SC
29715-6956
US

IV. Provider business mailing address

908 SMITHFIELD WAY STE 101
FORT MILL SC
29715-6956
US

V. Phone/Fax

Practice location:
  • Phone: 803-220-2782
  • Fax: 803-233-2968
Mailing address:
  • Phone: 803-220-2782
  • Fax: 803-233-2968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number2021-01360
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number20-91304
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: