Individual
DR. MICHAEL R. MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
122 12TH ST, PRINCETON, WV 24740
(304) 487-7000
Mailing address
PO BOX 634715, CINCINNATI, OH 45263-0001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
727
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0049640-000
—
WV
01
—
10243211
MEDICAID VIRGINIA
VA
01
—
1058671
WEST VIRGINIA WORKERS COM
WV
01
—
59039
UNICARE HEALTHPLAN
WV
01
—
760729179-093
BSMT
WV
01
—
P00021637
MEDICARE RAILROAD
WV
Enumeration date
06/09/2006
Last updated
11/09/2007
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