Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | C1-0012543 | DE |
N | 111NI0900X | Internist | C1-0012543 | DE |
Y | 207R00000X | Internist | MD045357E | PA |
Y | 111NI0900X | Internist | MD045357E | PA |
N | 207RA0401X | Internist - Addiction Medicine | MD045357E | PA |
NPI | 1790707511 |
---|---|
Provider Name | Steven Mills |
First Address | Smyrna, DE 19977-4051 |
Second Address | Camden, DE 19134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 06/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001262170 | (05) | PA |
117015 | CBH (01) | PA |
790000016 | RR MEDICARE (01) | PA |
81-1317693 | (05) | DE |
C31784 | (02) |