Individual
MR. ANTHONY DWAYNE MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
770 OLD ROSWELL PL, SUITE J100, ROSWELL, GA 30076-1670
(404) 547-7450
(770) 643-2011
Mailing address
770 OLD ROSWELL PL, SUITE J100, ROSWELL, GA 30076-1670
(404) 547-7450
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
044023
GA
207V00000X
Obstetrics & Gynecology Physician
044023
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000762088D
—
GA
01
—
044023
GA MEDICAL LIC
GA
01
—
11343981
CAQH IDENTIFIER
GA
01
—
36092640
ILLINOIS MEDICAL LIC
IL
Enumeration date
06/20/2006
Last updated
04/14/2011
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