Organization
DANA ELLEN MACMILLAN M D P L L C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DANA ELLEN MACMILLAN MD (OWNER)
(248) 336-8275
Entity
Organization
Contact information
Practice address
25600 WOODWARD AVE, SUITE 101, ROYAL OAK, MI 48067-0943
(248) 336-8278
Mailing address
25600 WOODWARD AVE, SUITE 101, ROYAL OAK, MI 48067-0943
(248) 336-8278
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301404641
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558497578
PERSONAL
MI
Enumeration date
02/25/2009
Last updated
02/25/2009
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