Provider Demographics
NPI:1861794380
Name:HERTIG, MEGAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:HERTIG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3457 HILLSBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3008
Mailing Address - Country:US
Mailing Address - Phone:919-384-9880
Mailing Address - Fax:
Practice Address - Street 1:3457 HILLSBOROUGH RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3008
Practice Address - Country:US
Practice Address - Phone:919-384-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-04
Last Update Date:2010-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21297183500000X
OH03328552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist