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NPI Code Detail

MEDICARE: AMY ELIZABETH MILITO D.O.

MEDICARE: AMY ELIZABETH MILITO D.O.
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
1390200000XStudent in an Organized Health Care Education/Training Program5101021262MI
2207Q00000XFamily Medicine Physician5101021262MI

General Provider Information

NPI Number : 1871907097
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY ELIZABETH MILITO D.O.
Provider Business Mailing Address
First Line : PO BOX 1848
Second Line :
City : MUSKEGON
State : MI
Zip : 49443-1848
Country : US
Telephone Number : 231-672-7900
Fax Number : 231-727-7931
Provider Business Practice Location Address
First Line : 6401 PRAIRIE ST STE 2600
Second Line :
City : NORTON SHORES
State : MI
Zip : 49444-7842
Country : US
Telephone Number : 231-672-7900
Fax Number : 231-727-7931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2014
Last Update Date : 04/06/2021

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