Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 0632 | AZ |
NPI | 1043311020 |
---|---|
Provider Name | Dr. Peter Donald Milbrandt |
First Address | Phoenix, AZ 85020-5251 |
Second Address | Phoenix, AZ 85020-5251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/07/2007 |