Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 2903599-8208 | AZ |
NPI | 1184749491 |
---|---|
Provider Name | Dr. David Thomas Millward |
First Address | Tucson, AZ 85745-9039 |
Second Address | Tucson, AZ 85721-0095 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 01/10/2008 |