Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | LL9928 | MD |
N | 213E00000X | Podiatrist | LL9928 | MD |
N | 222Z00000X | Podiatrist | LL9928 | MD |
Y | 213ES0103X | Foot & Ankle Surgery | LL9928 | MD |
NPI | 1194176297 |
---|---|
Provider Name | Dr. Kelsey Millonig |
First Address | Des Moines, IA 50315-3922 |
Second Address | Baltimore, MD 21215-5216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2016 |
Last Update Date | 29/06/2020 |