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General NPI Number Information
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NPI Number | 1336363878
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Entity Type | Individual
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Provider Name | KEITH ALLEN MILHOAN DO
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Gender | Male
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 210 CHARLES ST
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City | SISTERSVILLE
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State | WV
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Zip | 26175-1202
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Country | US
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Telephone | 304-447-2004
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Fax | 304-447-2005
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Provider Business Mailing Address
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Address Line | 3103 9TH AVE
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City | VIENNA
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State | WV
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Zip | 26105-2423
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Country | US
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Telephone | 304-615-6441
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Fax | 304-447-2005
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3407
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License Number State | WV
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