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NPI Code Detail

MEDICARE: MEGAN F JEWELL MD

MEDICARE: MEGAN F JEWELL MD
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
1207V00000XObstetrics & Gynecology Physician101586CA

General Provider Information

NPI Number : 1588841712
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN F JEWELL MD
Provider Business Mailing Address
First Line : 1111 EMERALD BAY RD
Second Line :
City : SOUTH LAKE TAHOE
State : CA
Zip : 96150-6207
Country : US
Telephone Number : 530-543-5659
Fax Number : 530-541-8723
Provider Business Practice Location Address
First Line : 2175 SOUTH AVE
Second Line :
City : SOUTH LAKE TAHOE
State : CA
Zip : 96150-7024
Country : US
Telephone Number : 530-543-5711
Fax Number : 530-544-2503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2008
Last Update Date : 04/25/2018

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