MEDICARE: DR. PAUL J MILLEA MD

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
1	207Q00000X	Family Medicine Physician	MD039129	MD
2	207Q00000X	Family Medicine Physician	D65501	MD
3	207Q00000X	Family Medicine Physician	0101240677	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000011354F	OTHER		HUMANA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326099177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL J MILLEA MD

Provider Business Mailing Address
First Line	:	2101 E JEFFERSON ST
Second Line	:	KAISER PERMANENTE MEDICARE ENROLLMENT
City	:	ROCKVILLE
State	:	MD
Zip	:	20852-4908
Country	:	US
Telephone Number	:	301-816-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 N WASHINGTON ST
Second Line	:	KAISER PERMANENTE FALLS CHURCH MEDICAL CENTER
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-4518
Country	:	US
Telephone Number	:	703-237-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	02/04/2022

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