Healthcare Provider Details

I. General information

NPI: 1649633215
Provider Name (Legal Business Name): HUAN M. MILLS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WASHINGTON ST # 450
BOSTON MA
02111-1552
US

IV. Provider business mailing address

35 ROSSMORE RD
BOSTON MA
02130-3795
US

V. Phone/Fax

Practice location:
  • Phone: 617-636-4648
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number270990
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number282942
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: