Provider Demographics
NPI:1194087643
Name:FERENCE, MEGAN (MD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:FERENCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 E. PACES FERRY RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-583-9540
Mailing Address - Fax:
Practice Address - Street 1:455 E. PACES FERRY RD
Practice Address - Street 2:SUITE 212
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305
Practice Address - Country:US
Practice Address - Phone:404-261-2666
Practice Address - Fax:404-261-2669
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015015455208000000X
GA78457208000000X
KS04-38033208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics