Provider Demographics
NPI:1295135556
Name:DELGADO, MEGAN LINDSEY (PHARMD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LINDSEY
Last Name:DELGADO
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 1:110 MITCHELLS CHANCE RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-2740
Mailing Address - Country:US
Mailing Address - Phone:410-957-9411
Mailing Address - Fax:
Practice Address - Street 1:110 MITCHELLS CHANCE RD
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2740
Practice Address - Country:US
Practice Address - Phone:410-957-9411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-23
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP13636183500000X
MD22815183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD22815OtherMARYLAND BOARD OF PHARMACY
MSP13636OtherMISSISSIPPI BOARD OF PHARMACY