Individual
MEGAN DILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11175 205TH ST W, LAKEVILLE, MN 55044-9827
(952) 388-1212
Mailing address
1110 YANKEE DOODLE RD, SAINT PAUL, MN 55121-2092
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
65763
MN
208000000X
Pediatrics Physician
65763
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
873169698
—
MN
Enumeration date
07/01/2015
Last updated
05/25/2022
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