Provider Demographics
NPI:1093710360
Name:MILNER, MARK R (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:R
Last Name:MILNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 WYMAN PARK DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6410 ROCKLEDGE DR
Practice Address - Street 2:STE 200
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1830
Practice Address - Country:US
Practice Address - Phone:301-897-5301
Practice Address - Fax:301-564-4289
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041520207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD12470008OtherBCBS
MD493857OtherNCPPO
MD5366810011Medicaid
MD122018OtherAETNA
MD25091OtherMDIPA
MD177656Medicare PIN
MDC62835Medicare UPIN