Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MT192696 | PA |
NPI | 1013178474 |
---|---|
Provider Name | Megan Elizabeth Gresh |
First Address | Philadelphia, PA 19134-1043 |
Second Address | Philadelphia, PA 19134-1043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2008 |
Last Update Date | 19/02/2014 |