Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 9901264 | NC |
NPI | 1053305425 |
---|---|
Provider Name | Dr. Raymundo V Millan |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-2818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 16/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1240J | BCBS NC (01) | NC |
250011157 | RAILROAD MEDICARE (01) | NC |
891240J | (05) | NC |
H08280 | (02) | NC |