Provider Information for 1750855714
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CARRIE MEGA
Sex: Female
NPI: 1750855714
Last Updated: 2019-01-13
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1750855714 | ||||||||
| Enumeration Date | 2019-01-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 88 HIDDEN SPRINGS CT DOTHAN, AL 36305-6409 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 187 BELMONT DR DOTHAN, AL 36305-6500 United States Phone: 334-671-1280 | Fax: | ||||||||
| Secondary Practice Address(es) | 187 BELMONT DR. | ||||||||
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