Healthcare Provider Details

I. General information

NPI: 1639465479
Provider Name (Legal Business Name): CYNTHIA JAPHET MILLWARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CYNTHIA FLORENCE JAPHET M.D.

II. Dates (important events)

Enumeration Date: 06/20/2011
Last Update Date: 07/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 E STAR CT SUITE A
MONTROSE CO
81401-6704
US

IV. Provider business mailing address

611 E STAR CT SUITE A
MONTROSE CO
81401-6704
US

V. Phone/Fax

Practice location:
  • Phone: 970-249-4321
  • Fax:
Mailing address:
  • Phone: 970-249-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4050
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: