Healthcare Provider Details

I. General information

NPI: 1558564716
Provider Name (Legal Business Name): MILLICENT G. ZACHER, DO, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 E LANCASTER AVE SUITE 103
ARDMORE PA
19003-2321
US

IV. Provider business mailing address

233 E LANCASTER AVE SUITE 103
ARDMORE PA
19003-2321
US

V. Phone/Fax

Practice location:
  • Phone: 610-642-1442
  • Fax: 610-642-1344
Mailing address:
  • Phone: 610-642-1442
  • Fax: 610-642-1344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberOS004380L
License Number StatePA

VIII. Authorized Official

Name: DR. MILLICENT G. ZACHER
Title or Position: PRESIDENT
Credential: DO
Phone: 610-642-1442