Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | DO 00423 | RI |
NPI | 1366517666 |
---|---|
Provider Name | Dr. Lisa L. Milder |
First Address | East Greenwich, RI 02818-1730 |
Second Address | East Greenwich, RI 02818-1730 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 05/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0101654 | UNITED HEALTH CARE (01) | RI |
3099-5 | (02) | RI |
759423 | (02) | RI |