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NPI Code Detail

MEDICARE: MEGAN M MICHAEL PA-C

MEDICARE: MEGAN M MICHAEL PA-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
1363A00000XPhysician Assistant2021043681MO

General Provider Information

NPI Number : 1629318829
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN M MICHAEL PA-C
Provider Business Mailing Address
First Line : 10010 KENNERLY RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63128-2106
Country : US
Telephone Number : 314-525-1906
Fax Number : 314-525-4148
Provider Business Practice Location Address
First Line : 10010 KENNERLY RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63128-2106
Country : US
Telephone Number : 314-525-1906
Fax Number : 314-525-4148
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2013
Last Update Date : 05/08/2026

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