Provider Demographics
NPI:1154529246
Name:ENGELEN, MEGAN JEANETTE (DO)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:JEANETTE
Last Name:ENGELEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 E 3900 S STE 200
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1496
Mailing Address - Country:US
Mailing Address - Phone:385-743-1051
Mailing Address - Fax:385-364-0051
Practice Address - Street 1:1377 E 3900 S STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1496
Practice Address - Country:US
Practice Address - Phone:385-743-1051
Practice Address - Fax:385-364-0051
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8262344207R00000X
UT8262344-1204207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine