Provider Demographics
NPI:1679758023
Name:SMITH, MEGAN RAE (DC)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:RAE
Last Name:SMITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:RAE
Other - Last Name:BARCHIESI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:98 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:DE
Mailing Address - Zip Code:19970-9715
Mailing Address - Country:US
Mailing Address - Phone:302-402-3110
Mailing Address - Fax:
Practice Address - Street 1:98 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:OCEAN VIEW
Practice Address - State:DE
Practice Address - Zip Code:19970-9715
Practice Address - Country:US
Practice Address - Phone:302-402-3110
Practice Address - Fax:302-581-2251
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000774111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
184051Medicare PIN