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Individual

DR. MARK ARTHUR MILLEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3319 SPRING ST, DAVENPORT, IA 52807-2125
(563) 359-1641
(563) 359-4634
Mailing address
3319 SPRING ST, DAVENPORT, IA 52807-2125
(563) 359-1641
(563) 359-4634

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
036113576
IL
208800000X
Urology Physician
Primary
36143
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0464297
IA
01
1346229192
NPI# UROLOGICAL ASSC PC
IA
01
1346229192
NPI# UROLOGICAL ASSC PC
IL
01
1464297
IA XIX# FOR ILLINOIS PTS
IA
01
P00260899
MEDICARE RAILROAD
IA
01
P00618141
MEDICARE RAILROAD
IL
Enumeration date
05/27/2005
Last updated
05/08/2013
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