MEDICARE: MEGAN VAN WYHE

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1306351523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN VAN WYHE

Provider Business Mailing Address
First Line	:	1462 WALKER AVE NW
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49504-3944
Country	:	US
Telephone Number	:	616-247-3815
Fax Number	:

Provider Business Practice Location Address
First Line	:	1462 WALKER AVE NW
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49504-3944
Country	:	US
Telephone Number	:	616-247-3815
Fax Number	:

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

Provider Enumeration Date	:	12/11/2017
Last Update Date	:	01/19/2026

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Directions to “ MEGAN VAN WYHE ” Practice Location

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