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General NPI Number Information
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NPI Number | 1871621268
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Entity Type | Organization
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Legal Business Name | PREMIUM HEALTH, P.C.
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 141 SECOND STREET PIKE
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City | SOUTHAMPTON
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State | PA
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Zip | 18966
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Country | US
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Telephone | 215-942-4646
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Fax | 215-942-4801
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Provider Business Mailing Address
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Address Line | 141 SECOND STREET PIKE
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City | SOUTHAMPTON
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State | PA
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Zip | 18966
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Country | US
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Telephone | 215-942-4646
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Fax | 215-942-4801
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIA MILCU
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Credential | M.D.
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Telephone | 610-308-4781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | MD043486L
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License Number State | PA
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