Provider Demographics
NPI:1417302233
Name:SEBESTA, MEGYN ROSE (DO)
Entity type:Individual
Prefix:DR
First Name:MEGYN
Middle Name:ROSE
Last Name:SEBESTA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MEGYN
Other - Middle Name:ROSE
Other - Last Name:BEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:WAKE FOREST BAPTIST MEDICAL
Mailing Address - Street 2:MEDICAL CENTER BOULEVARD
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-2694
Mailing Address - Fax:
Practice Address - Street 1:WAKE FOREST BAPTIST MEDICAL
Practice Address - Street 2:MEDICAL CENTER BOULEVARD
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-2694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-00830208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics