Provider Demographics
NPI:1326160987
Name:DR.'S AMMLUNG MILTO & ASSOCIATES P.A.
Entity Type:Organization
Organization Name:DR.'S AMMLUNG MILTO & ASSOCIATES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:AMMLUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-788-7030
Mailing Address - Street 1:516 N ROLLING RD
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4140
Mailing Address - Country:US
Mailing Address - Phone:410-788-7030
Mailing Address - Fax:410-869-9636
Practice Address - Street 1:516 N ROLLING RD
Practice Address - Street 2:SUITE 204
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4140
Practice Address - Country:US
Practice Address - Phone:410-788-7030
Practice Address - Fax:410-869-9636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD25234207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD992LMedicare ID - Type Unspecified