Healthcare Provider Details

I. General information

NPI: 1376607705
Provider Name (Legal Business Name): STEFEN DEWITT MCMILLAN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEVE DEWITT MCMILLAN RN

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10903 NEW HAMPSHIRE AVE
SILVER SPRING MD
20993-7105
US

IV. Provider business mailing address

WHITE OAK
SILVER SPRING MD
20993-0001
US

V. Phone/Fax

Practice location:
  • Phone: 888-463-6332
  • Fax:
Mailing address:
  • Phone: 301-796-3018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN180623
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN180623
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: