Individual
DR. MICHELLE MILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
630 RIDGE RD, MUNSTER, IN 46321-1610
(219) 836-1738
(219) 836-2822
Mailing address
630 RIDGE RD, MUNSTER, IN 46321-1610
(219) 836-1738
(219) 836-2822
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002899AB
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0407090001
DME MAC
IN
Enumeration date
02/16/2007
Last updated
04/06/2009
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