Provider Demographics
NPI:1407052996
Name:WOOD, MEGAN DANIELLE (MD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:DANIELLE
Last Name:WOOD
Suffix:
Gender:
Credentials:MD
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:DANIELLE
Other - Last Name:VANDERLINDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10345 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127
Mailing Address - Country:US
Mailing Address - Phone:314-384-3584
Mailing Address - Fax:314-965-6067
Practice Address - Street 1:10345 WATSON RD
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127
Practice Address - Country:US
Practice Address - Phone:314-384-3584
Practice Address - Fax:314-965-6067
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA43312207R00000X
FLME112263207RE0101X
MO2023039971207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200133751Medicaid