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General NPI Number Information
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NPI Number | 1003296336
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Entity Type | Individual
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Provider Name | CALEB MILLS MD
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Gender | Male
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER BLVD WAKE FOREST BAPTIST MEDICAL CENTER
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City | WINSTON-SALEM
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State | NC
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Zip | 27103
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Country | US
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Telephone | 336-716-2011
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Fax |
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Provider Business Mailing Address
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Address Line | ASSOCIATED RADIOLOGISTS, INC. 1120 KANAWHA BLVD E
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City | CHARLESTON
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State | WV
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Zip | 25301-2400
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Country | US
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Telephone | 304-344-3457
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Fax | 304-344-3480
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 30289
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License Number State | WV
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