Provider Demographics
NPI:1497812911
Name:MCMILLIAN, URSULA (MD)
Entity Type:Individual
Prefix:DR
First Name:URSULA
Middle Name:
Last Name:MCMILLIAN
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 1:330 ORCHARD ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4417
Mailing Address - Country:US
Mailing Address - Phone:203-867-5508
Mailing Address - Fax:203-867-5509
Practice Address - Street 1:330 ORCHARD ST
Practice Address - Street 2:SUITE 111
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4417
Practice Address - Country:US
Practice Address - Phone:203-867-5508
Practice Address - Fax:203-867-5509
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT048483208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery