Provider Demographics
NPI:1912264888
Name:BERTKE, MEGAN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:MARIE
Last Name:BERTKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:203 JOHN WESLEY WAY
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-1446
Mailing Address - Country:US
Mailing Address - Phone:502-795-4885
Mailing Address - Fax:
Practice Address - Street 1:4001 DUTCHMANS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-895-4607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-17
Last Update Date:2018-08-09
Deactivation Date:2018-07-25
Deactivation Code:
Reactivation Date:2018-08-01
Provider Licenses
StateLicense IDTaxonomies
KY48086207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine