Provider Demographics
NPI:1063429421
Name:TEMP, MEGAN E (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:TEMP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:744 S WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-3505
Mailing Address - Country:US
Mailing Address - Phone:920-445-7222
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:2641 DEVELOPMENT DR
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-4240
Practice Address - Country:US
Practice Address - Phone:920-338-6868
Practice Address - Fax:920-338-6869
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI44408-020207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44408-020OtherMEDICAL LICENSE
WIH59203Medicare UPIN