Individual
MEGAN MUKAVETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1100 E MICHIGAN AVE STE 307, JACKSON, MI 49201-1850
(517) 205-7605
Mailing address
1100 E MICHIGAN AVE, JACKSON, MI 49201-1847
(517) 205-7605
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008959
MI
363A00000X
Physician Assistant
PA60948597
WA
363A00000X
Physician Assistant
PA9103210
FL
363AS0400X
Surgical Physician Assistant
PA9103210
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292128600
—
FL
01
—
P00207686
RAILROAD MEDICARE
—
Enumeration date
06/26/2006
Last updated
11/13/2023
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