Provider Demographics
NPI:1528293123
Name:HIGGINS, MEGAN E (LD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 HARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:ME
Mailing Address - Zip Code:04573-3208
Mailing Address - Country:US
Mailing Address - Phone:207-563-3368
Mailing Address - Fax:
Practice Address - Street 1:40 HARRINGTON RD
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:ME
Practice Address - Zip Code:04573-3208
Practice Address - Country:US
Practice Address - Phone:207-563-3368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME5510122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME433127099Medicaid