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Megan M Derazin
Military Health Care Provider in Fort Stewart, Georgia
NPI 1649896986

Megan M Derazin is a Military Health Care Provider based in Fort Stewart, GA. Megan M Derazin practices in Fort Stewart, GA. The NPI Number for Megan M Derazin is 1649896986 and holds a License No. (Georgia).

The current practice location address for Megan M Derazin is 1061 Harmon Ave, Fort Stewart, GA and can be reached out via phone at 912-435-6965.

Location: 1061 Harmon Ave, Fort Stewart, GA, 31314-5641
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649896986
Provider Name
Megan M Derazin
Credential
Provider Entity Type
Individual
Gender
Female
Address
1061 Harmon Ave, Fort Stewart, GA, 31314-5641
Phone Number
912-435-6965
Fax Number
Provider Enumeration Date
06/23/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1061 Harmon Ave
City
Fort Stewart
State
Georgia
Zip
31314-5641
Phone Number
912-435-6965
Fax Number
person
Provider Business Mailing Address Details
Address
1061 Harmon Ave
City
Fort Stewart
State
Georgia
Zip
31314-5641
Phone Number
912-435-6965
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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