MEDICARE: GARY A. MILLES, M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1487776662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARY A. MILLES, M.D., P.A.

Provider Business Mailing Address
First Line	:	8186 LARK BROWN RD
Second Line	:	SUITE 203
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6433
Country	:	US
Telephone Number	:	410-799-8860
Fax Number	:

Provider Business Practice Location Address
First Line	:	8186 LARK BROWN RD
Second Line	:	SUITE 203
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6433
Country	:	US
Telephone Number	:	410-799-8860
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PHYSCIAN
Name	:	GARY A. MILLES
Credential	:	M.D.
Telephone Number	:	410-799-8860

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	06/21/2018

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