Provider Demographics
NPI:1679132195
Name:MCMURRAY BIRES, MEGAN RENNEE (DO)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:RENNEE
Last Name:MCMURRAY BIRES
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:RENNEE
Other - Last Name:MCMURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 19665
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62794-9665
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 N 8TH ST # 4B143C
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62701-1041
Practice Address - Country:US
Practice Address - Phone:217-545-3262
Practice Address - Fax:217-545-7305
Is Sole Proprietor?:No
Enumeration Date:2019-06-08
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125074607208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology