Provider Demographics
NPI:1043491079
Name:MILNE EYE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:MILNE EYE MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:MILNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-681-9797
Mailing Address - Street 1:10313 GEORGIA AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5006
Mailing Address - Country:US
Mailing Address - Phone:301-681-9797
Mailing Address - Fax:301-681-6855
Practice Address - Street 1:10313 GEORGIA AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5006
Practice Address - Country:US
Practice Address - Phone:301-681-9797
Practice Address - Fax:301-681-6855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6063Medicare PIN
DC686432Medicare PIN
C62257Medicare UPIN