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Individual

STEVAN J. MILHOAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2200 GRAND CENTRAL AVE, STE 110, VIENNA, WV 26105-1300
(304) 295-9000
(304) 295-0605
Mailing address
2200 GRAND CENTRAL AVE, STE 110, VIENNA, WV 26105-1300
(304) 295-9000
(304) 295-0605

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
15193
WV
207R00000X
Internal Medicine Physician
Primary
15193
WV
208000000X
Pediatrics Physician
15193
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001721378
BC/BS
WV
05
0074018000
WV
05
0853250
OH
Enumeration date
12/30/2005
Last updated
08/29/2008
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