Healthcare Provider Details

I. General information

NPI: 1144353582
Provider Name (Legal Business Name): MEGAN K CASSIDY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 KOGER CENTER BLVD
NORTH CHESTERFIELD VA
23235-4778
US

IV. Provider business mailing address

1212 KOGER CENTER BLVD
NORTH CHESTERFIELD VA
23235-4778
US

V. Phone/Fax

Practice location:
  • Phone: 804-897-2100
  • Fax: 804-897-9074
Mailing address:
  • Phone: 804-897-2100
  • Fax: 804-897-9074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number0101241926
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: