MEDICARE: MIKALA MORGAN MCMILLAN PA

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	390200000X	Student in an Organized Health Care Education/Training Program
2	363A00000X	Physician Assistant	001014001	NC

General Provider Information

NPI Number	:	1376232827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIKALA MORGAN MCMILLAN PA

Provider Business Mailing Address
First Line	:	640 SUMMIT CROSSING PL STE 203
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-2142
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 SUMMIT CROSSING PL STE 203
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-2142
Country	:	US
Telephone Number	:	704-237-4240
Fax Number	:

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

Provider Enumeration Date	:	05/02/2023
Last Update Date	:	06/05/2026

Similar Medicare Providers

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Practice Location Address:

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28054-2142

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Practice Fax:

1124098165 — DR. ANN M HOSCHEIT O.D.
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1215908561 — MRS. CATHERINE ANN HOFFMAN MD
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1093786360 — DR. JOHN LAWRENCE SCHEITLER MD
Practice Location Address:

640 SUMMIT CROSSING PLACE , SUITE 204
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1245201557 — MR. JOHNATHAN DELEON WILLIAMS MD
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1851362503 — PIEDMONT ADULT & PEDIATRIC MEDICINE ASSOCIATES PA
Practice Location Address:

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Directions to “ MIKALA MORGAN MCMILLAN PA” Practice Location

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