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General NPI Number Information
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NPI Number | 1033538483
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Entity Type | Individual
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Provider Name | MEGAN B DIMOFF M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 04/19/2018
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Provider Practice Location Address
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Address Line | 150 S INGLESIDE ST STE 6
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City | FAIRHOPE
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State | AL
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Zip | 36532-1804
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Country | US
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Telephone | 251-928-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 115 OLD SHORT HILLS RD APT 493
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City | WEST ORANGE
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State | NJ
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Zip | 07052-1046
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Country | US
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Telephone | 251-604-3208
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35737
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License Number State | AL
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