Healthcare Provider Details

I. General information

NPI: 1508861956
Provider Name (Legal Business Name): AMI CHARISE MILTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 OREGON PIKE STE 107B
LANCASTER PA
17601-4206
US

IV. Provider business mailing address

409 SOUTH SECOND STREET SUITE 2F
HARRISBURG PA
17104-1612
US

V. Phone/Fax

Practice location:
  • Phone: 717-560-3505
  • Fax: 717-560-3531
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number204866
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: