Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 02004785A | IN |
NPI | 1013271865 |
---|---|
Provider Name | Scott John Milinovich |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Lafayette, IN 47905-8764 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2012 |
Last Update Date | 02/02/2022 |