Organization
TIDEWATER RADIATION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANETE M MILLS M.D. (OWNER)
(252) 384-4122
Entity
Organization
Contact information
Practice address
1144 N ROAD ST, ELIZABETH CITY, NC 27909-3473
(252) 384-4122
(252) 384-4220
Mailing address
PO BOX 31476, RICHMOND, VA 23294-1476
(804) 266-8717
(804) 266-5677
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
2013-00861
NC
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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