MEDICARE: DR. MEGHAN SHOGREN BIRT D.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5538	MN

General Provider Information

NPI Number	:	1124314406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGHAN SHOGREN BIRT D.C

Provider Business Mailing Address
First Line	:	8675 MARIGOLD CIR
Second Line	:	#106
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-7657
Country	:	US
Telephone Number	:	918-327-9610
Fax Number	:	763-425-2676

Provider Business Practice Location Address
First Line	:	8509 JEFFERSON LN N
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55445-2119
Country	:	US
Telephone Number	:	763-425-4577
Fax Number	:	763-425-2676

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2011
Last Update Date	:	07/25/2011

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