Organization
W MILYANI MD PLLC
Active
Other names
Frontier Skin and Cancer
Organization subpart
No
Provider details
NPI number
Authorized official
CLINTON MARTIN PA-C (MEMBER)
(928) 963-9333
Entity
Organization
Contact information
Practice address
1951 MESQUITE AVE STE F, LAKE HAVASU CITY, AZ 86403-5746
(725) 867-7126
Mailing address
9101 W SAHARA AVE # 105-1, LAS VEGAS, NV 89117-5772
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013228394
NPI
—
01
—
1396847182
NPI
—
01
—
1497089874
NPI
—
01
—
1538896238
NPI
UT
Enumeration date
05/09/2022
Last updated
01/09/2023
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