MEDICARE: MEGHAN JOYCE WELTMAN MPAS

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	363AM0700X	Medical Physician Assistant	OA003859	PA

General Provider Information

NPI Number	:	1154639722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN JOYCE WELTMAN MPAS

Provider Business Mailing Address
First Line	:	675 N BROAD STREET EXT STE 5
Second Line	:
City	:	GROVE CITY
State	:	PA
Zip	:	16127-5805
Country	:	US
Telephone Number	:	724-458-5872
Fax Number	:	724-458-5972

Provider Business Practice Location Address
First Line	:	675 N BROAD STREET EXT STE 5
Second Line	:
City	:	GROVE CITY
State	:	PA
Zip	:	16127-5805
Country	:	US
Telephone Number	:	724-458-5872
Fax Number	:	724-458-5972

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

Provider Enumeration Date	:	09/16/2010
Last Update Date	:	07/21/2022

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