Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | ME31852 | FL |
NPI | 1013984939 |
---|---|
Provider Name | James E Mills |
First Address | Shalimar, FL 32579-1125 |
Second Address | Shalimar, FL 32579-1125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2006 |
Last Update Date | 04/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D54940 | (02) |