Provider Demographics
NPI:1417070327
Name:CALDWELL-MCMILLAN, MOLLY FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:FRANCES
Last Name:CALDWELL-MCMILLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:FRANCES
Other - Last Name:SARIKONDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12774 BOENKER LN
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2436
Mailing Address - Country:US
Mailing Address - Phone:314-291-7997
Mailing Address - Fax:314-739-1471
Practice Address - Street 1:12774 BOENKER LN
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2436
Practice Address - Country:US
Practice Address - Phone:314-291-9779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301083500207R00000X
MO2011001623207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine