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General NPI Number Information
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NPI Number | 1699736462
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Entity Type | Individual
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Provider Name | ROBERT MACMILLAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 10/10/2014
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Provider Practice Location Address
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Address Line | 8012 FRANKFORD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19136-2616
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Country | US
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Telephone | 215-624-1758
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Fax | 215-624-3153
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Provider Business Mailing Address
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Address Line | PO BOX 8500-8735
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City | PHILADELPHIA
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State | PA
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Zip | 19178-0001
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Country | US
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Telephone | 215-456-7000
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Fax | 215-254-2599
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD011831E
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License Number State | PA
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