Provider Demographics
NPI:1144518028
Name:WENGER, MEGHANN (PA-C)
Entity type:Individual
Prefix:MS
First Name:MEGHANN
Middle Name:
Last Name:WENGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-949-2777
Mailing Address - Fax:717-949-6925
Practice Address - Street 1:2496 STIEGEL PIKE
Practice Address - Street 2:
Practice Address - City:SCHAEFFERSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17088-7021
Practice Address - Country:US
Practice Address - Phone:717-949-2777
Practice Address - Fax:717-949-6925
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA005791363AS0400X
PAMA055011363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA229895Medicare PIN