Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 104297 | MN |
N | 207RC0000X | Internist - Cardiovascular Disease | 16635 | NH |
N | 207RC0000X | Internist - Cardiovascular Disease | 52182 | MN |
Y | 207RI0011X | Interventional Cardiology | 16635 | NH |
N | 207RI0011X | Interventional Cardiology | 62672 | TN |
NPI | 1003961772 |
---|---|
Provider Name | Megan J Coylewright |
First Address | Lebanon, NH 03756-1000 |
Second Address | Chattanooga, TN 37403-2147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 02/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00787806 | RAILROAD MEDICARE (01) | MN |