Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 0431328 | NV |
NPI | 1497848626 |
---|---|
Provider Name | Milton Mcnichol |
First Address | Maitland, FL 32751-8406 |
Second Address | Maitland, FL 32751-8406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 06/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F70205 | (02) |