Provider Demographics
NPI:1366683682
Name:FOJAS, MILLIECOR ITUGOT (MD)
Entity Type:Individual
Prefix:
First Name:MILLIECOR
Middle Name:ITUGOT
Last Name:FOJAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 N MARINE CORPS DR
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-4308
Mailing Address - Country:US
Mailing Address - Phone:671-647-8262
Mailing Address - Fax:
Practice Address - Street 1:1244 N MARINE CORPS DR
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-4308
Practice Address - Country:US
Practice Address - Phone:671-647-8262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2012-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUM1675208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics