Healthcare Provider Details

I. General information

NPI: 1568601292
Provider Name (Legal Business Name): LOURDES E MILCIUNAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 TURNBERRY LN
CASHIERS NC
28717
US

IV. Provider business mailing address

PO BOX 1821
CASHIERS NC
28717-1821
US

V. Phone/Fax

Practice location:
  • Phone: 828-743-5559
  • Fax: 828-743-5559
Mailing address:
  • Phone: 828-743-5559
  • Fax: 828-743-5559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200000097
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: