Healthcare Provider Details

I. General information

NPI: 1104951110
Provider Name (Legal Business Name): MEGHAN L. MILBURN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 01/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MEDICAL PKWY
ANNAPOLIS MD
21401
US

IV. Provider business mailing address

201 DEFENSE HWY STE 100
ANNAPOLIS MD
21401-8902
US

V. Phone/Fax

Practice location:
  • Phone: 443-481-5300
  • Fax: 443-481-6705
Mailing address:
  • Phone: 443-481-6580
  • Fax: 443-481-4151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberD64886
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: