Healthcare Provider Details

I. General information

NPI: 1124935069
Provider Name (Legal Business Name): ABIGAIL MARIE MCMILLIAN MSPAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 EISENHOWER DR
HANOVER PA
17331-5248
US

IV. Provider business mailing address

42 KATELYN DR
NEW OXFORD PA
17350-6100
US

V. Phone/Fax

Practice location:
  • Phone: 717-633-0031
  • Fax:
Mailing address:
  • Phone: 443-823-4633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: