Provider Demographics
NPI:1295836914
Name:MILLINER, ALAN S (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:S
Last Name:MILLINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:200 HYGEIA DR
Mailing Address - Street 2:CCHS PHYSICIAN CONTRACTING, SUITE 2300
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2600 GLASGOW AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-4773
Practice Address - Country:US
Practice Address - Phone:302-836-8350
Practice Address - Fax:302-836-1906
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC1-0003172207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA72209Medicare UPIN
DE620461Medicare ID - Type Unspecified