Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 4544 | SC |
N | 213EG0000X | General Practice | 4544 | SC |
Y | 1223G0001X | General Practice | 8626 | KY |
Y | 213EG0000X | General Practice | 8626 | KY |
NPI | 1992958656 |
---|---|
Provider Name | Dr. Megan Anne Degaris |
First Address | Louisville, KY 40202 |
Second Address | Louisville, KY 40207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 30/01/2013 |