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NPI Code Detail

MEDICARE: DR. GEORGE ALFRED MCMILLAN M.D.

MEDICARE: DR. GEORGE ALFRED MCMILLAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician114606-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P1219635OTHERNYOXFORD HEALTH PLAN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30004210854OTHERNYAETNA

General Provider Information

NPI Number : 1316930753
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE ALFRED MCMILLAN M.D.
Provider Business Mailing Address
First Line : 14732 JAMAICA AVE
Second Line :
City : JAMAICA
State : NY
Zip : 11435-4042
Country : US
Telephone Number : 718-786-5000
Fax Number : 718-291-4214
Provider Business Practice Location Address
First Line : 14732 JAMAICA AVE
Second Line :
City : JAMAICA
State : NY
Zip : 11435-4042
Country : US
Telephone Number : 718-786-5000
Fax Number : 718-291-4214
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 02/15/2016

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