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General NPI Number Information
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NPI Number | 1902138761
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Entity Type | Individual
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Provider Name | CHRISTIAN RICHARD MILLETT M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 2616 SHERWOOD HALL LN STE 306
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City | ALEXANDRIA
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State | VA
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Zip | 22306-3154
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Country | US
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Telephone | 571-334-6323
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Fax | 571-400-2030
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Provider Business Mailing Address
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Address Line | PO BOX 734240
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City | CHICAGO
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State | IL
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Zip | 60673-4240
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Country | US
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Telephone | 708-634-4602
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Fax | 571-400-2030
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 01012506368
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License Number State | VA
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