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General NPI Number Information
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NPI Number | 1295066678
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Entity Type | Organization
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Legal Business Name | GREGORY D MILLS DPM LLC
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Dates
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Enumeration Date | 01/25/2010
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 1930 ROUTE 70 E STE L60 THE EXECUTIVE MEWS
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City | CHERRY HILL
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State | NJ
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Zip | 08003-4201
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Country | US
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Telephone | 856-751-3313
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Fax | 856-751-8370
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Provider Business Mailing Address
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Address Line | 1930 ROUTE 70 E STE L60 THE EXECUTIVE MEWS
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City | CHERRY HILL
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State | NJ
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Zip | 08003-4201
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Country | US
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Telephone | 856-751-3313
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Fax | 856-751-8370
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Authorized Official
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Title or Position | MEMBER
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Name | DR. GREGORY MILLS
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Credential | DPM
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Telephone | 856-751-3313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | MD1968
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License Number State | NJ
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