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General NPI Number Information
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NPI Number | 1851404214
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Entity Type | Individual
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Provider Name | PHILIP DANIEL MILLET M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 143 CANAL ST SUITE 200
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City | POOLER
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State | GA
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Zip | 31322-6007
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Country | US
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Telephone | 912-748-4527
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Fax | 912-748-9016
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Provider Business Mailing Address
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Address Line | 2 JOHNNY MERCER BLVD APT. 1102
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City | SAVANNAH
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State | GA
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Zip | 31410-3329
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Country | US
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Telephone | 912-898-4047
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 058077
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License Number State | GA
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