Healthcare Provider Details

I. General information

NPI: 1679729354
Provider Name (Legal Business Name): KIM HUTCHINS MILLAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 08/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N. HARRISON ST. PRINCETON NASSAU PEDIATRICS
PRINCETON NJ
08540
US

IV. Provider business mailing address

301 N. HARRISON ST. PRINCETON NASSAU PEDIATRICS
PRINCETON NJ
08540
US

V. Phone/Fax

Practice location:
  • Phone: 609-924-5510
  • Fax: 609-924-3577
Mailing address:
  • Phone: 609-924-5510
  • Fax: 609-924-3577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA04994000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: