MEDICARE: MICHAEL MEILEN MILGRAUM PHD

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	103T00000X	Psychologist	03843	MD

General Provider Information

NPI Number	:	1518948371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL MEILEN MILGRAUM PHD

Provider Business Mailing Address
First Line	:	3717 DECATUR AVE STE 1
Second Line	:
City	:	KENSINGTON
State	:	MD
Zip	:	20895-2148
Country	:	US
Telephone Number	:	301-980-3997
Fax Number	:

Provider Business Practice Location Address
First Line	:	3717 DECATUR AVE STE 1
Second Line	:
City	:	KENSINGTON
State	:	MD
Zip	:	20895-2148
Country	:	US
Telephone Number	:	301-980-3997
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	12/24/2025

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