Healthcare Provider Details

I. General information

NPI: 1326464777
Provider Name (Legal Business Name): EUGENE MCMILLEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2014
Last Update Date: 03/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30207 FRANKFORD SCHOOL RD
FRANKFORD DE
19945-2616
US

IV. Provider business mailing address

31 HOSIER ST
SELBYVILLE DE
19975-9300
US

V. Phone/Fax

Practice location:
  • Phone: 302-732-3800
  • Fax:
Mailing address:
  • Phone: 302-436-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberL1-0028600
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: