Individual
MEGHAN GRACE DURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1211 FISH HATCHERY RD, MADISON, WI 53715-1909
(608) 252-8000
(608) 283-7160
Mailing address
1211 FISH HATCHERY RD, MADISON, WI 53715-1909
(608) 252-8000
(608) 283-7160
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54211
WI
207R00000X
Internal Medicine Physician
107143
MN
207R00000X
Internal Medicine Physician
125051198
IL
207R00000X
Internal Medicine Physician
54211
WI
208000000X
Pediatrics Physician
107143
MN
208000000X
Pediatrics Physician
125051198
IL
208000000X
Pediatrics Physician
54211
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609027580
—
WI
Enumeration date
10/09/2008
Last updated
05/24/2022
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