Provider Demographics
NPI:1508895749
Name:ZACHER, MILLICENT G (DO)
Entity Type:Individual
Prefix:DR
First Name:MILLICENT
Middle Name:G
Last Name:ZACHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 CHESTNUT ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4420
Mailing Address - Country:US
Mailing Address - Phone:215-955-5000
Mailing Address - Fax:215-923-1089
Practice Address - Street 1:833 CHESTNUT STREET
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4420
Practice Address - Country:US
Practice Address - Phone:215-955-5000
Practice Address - Fax:215-923-1089
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004380L207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010780350004Medicaid
PA1078035Medicare ID - Type Unspecified
PAC27709Medicare UPIN
PA021212PAGMedicare PIN