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NPI Code Detail

MEDICARE: MEGAN FASICK

MEDICARE:   MEGAN  FASICK
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
1207Q00000XFamily Medicine Physician82640SC
2207Q00000XFamily Medicine Physician35.144704OH

General Provider Information

NPI Number : 1437716990
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN FASICK
Provider Business Mailing Address
First Line : 3145 HAMILTON MASON RD STE 300
Second Line :
City : FAIRFIELD TOWNSHIP
State : OH
Zip : 45011-8556
Country : US
Telephone Number : 513-863-6222
Fax Number :
Provider Business Practice Location Address
First Line : 3145 HAMILTON MASON RD STE 300
Second Line :
City : FAIRFIELD TOWNSHIP
State : OH
Zip : 45011-8556
Country : US
Telephone Number : 513-863-6222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2019
Last Update Date : 09/06/2022

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Directions to “ MEGAN FASICK ” Practice Location

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