Provider Demographics
NPI:1316010846
Name:MILLMAN, JEFFREY DAVID (MD)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:DAVID
Last Name:MILLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1321 N MCCARRAN BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431
Mailing Address - Country:US
Mailing Address - Phone:775-331-1555
Mailing Address - Fax:775-331-8073
Practice Address - Street 1:1321 N MCCARRAN BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431
Practice Address - Country:US
Practice Address - Phone:775-331-1555
Practice Address - Fax:775-331-8073
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV4242207Q00000X
CAG24772207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2016515Medicaid
NV2016515Medicaid