Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC001443L | PA |
Y | 222Z00000X | Podiatrist | SC001443L | PA |
NPI | 1013945492 |
---|---|
Provider Name | Dr. Stephen J Mills |
First Address | Cheltenham, PA 19012 |
Second Address | Cheltenham, PA 19012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0506128 | (05) | PA |
T29614 | (02) |