MEDICARE: GEORGE MCMILLAN, M.D. AND ASSOCIATES, P.L.L.C.

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1720344138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGE MCMILLAN, M.D. AND ASSOCIATES, P.L.L.C.

Provider Business Mailing Address
First Line	:	614 EASTERN PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-1604
Country	:	US
Telephone Number	:	718-773-5310
Fax Number	:	718-735-6304

Provider Business Practice Location Address
First Line	:	614 EASTERN PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-1604
Country	:	US
Telephone Number	:	718-773-5310
Fax Number	:	718-735-6304

Authorized Official
Title or Position	:	MANAGING MEMBER/ PHYSICIAN
Name	:	DR. GEORGE A. MCMILLAN
Credential	:	M.D.
Telephone Number	:	718-773-5310

Provider Enumeration Date	:	04/10/2012
Last Update Date	:	04/10/2012

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