Individual
MEGAN FOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
468 CADIEUX RD, GROSSE POINTE, MI 48230-1507
(313) 473-6899
(313) 473-6899
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
(248) 577-9205
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011435
MI
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
06/17/2022
Last updated
02/14/2023
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