Provider Demographics
NPI:1205054632
Name:FOOTE, MEGHAN J (DO)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:J
Last Name:FOOTE
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:3985 MEDINA RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5968
Mailing Address - Country:US
Mailing Address - Phone:330-952-2251
Mailing Address - Fax:330-952-2261
Practice Address - Street 1:3985 MEDINA RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5968
Practice Address - Country:US
Practice Address - Phone:330-952-2251
Practice Address - Fax:330-952-2261
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2022-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34.009067207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2778409Medicaid
OHH225641Medicare PIN