Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | DC-007996-L | PA |
NPI | 1750386348 |
---|---|
Provider Name | Dr. Michael Aaron Mills |
First Address | Kittanning, PA 16201-8933 |
Second Address | Kittanning, PA 16201-8933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 15/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0018331350003 | (05) | PA |
U83932 | (02) | PA |