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General NPI Number Information
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NPI Number | 1730641176
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Entity Type | Individual
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Provider Name | MEGHANE ELIANE MASQUELIN DO
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Gender | Female
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 228 7TH ST SE
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City | WASHINGTON
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State | DC
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Zip | 20003-4306
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Country | US
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Telephone | 410-772-6909
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Fax |
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Provider Business Mailing Address
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Address Line | 228 7TH ST SE
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City | WASHINGTON
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State | DC
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Zip | 20003-4306
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036.161007
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H0097769
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0102208204
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO210012288
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License Number State | DC
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