Provider Demographics
NPI:1427378579
Name:RICHARDSON, MEGAN ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 CARAVEL DR
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1651
Mailing Address - Country:US
Mailing Address - Phone:302-650-8593
Mailing Address - Fax:
Practice Address - Street 1:92 OMEGA DR STE 92
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2065
Practice Address - Country:US
Practice Address - Phone:302-652-2225
Practice Address - Fax:302-340-7444
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000803111N00000X
NC4108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5916446Medicaid
2458090Medicare PIN