Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | 34007634 | OH |
Y | 2086S0105X | Surgery of the Hand | 34.007634 | OH |
NPI | 1770566283 |
---|---|
Provider Name | Gary M Millard |
First Address | Westerville, OH 43081-1397 |
Second Address | Westerville, OH 43081-1397 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 18/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0697974 | GROUP MEDICAID (01) | OH |
2252404 | (05) | OH |
H37028 | (02) | OH |
SP9213471 | GROUP MEDICARE (01) | OH |