Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 81401 | MA |
N | 2084N0400X | Neurologist | 81401 | MA |
Y | 2084N0402X | Child Neurologist | 81401 | MA |
NPI | 1124065891 |
---|---|
Provider Name | Dr. Jonathan Thomas Megerian |
First Address | Littleton, MA 01460-1439 |
Second Address | Orange, CA 92868-2801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 06/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3140652 | (05) | MA |
A2014601 | (02) | MA |