Provider Demographics
NPI:1538113139
Name:STELMAN, MILLA (MD)
Entity Type:Individual
Prefix:
First Name:MILLA
Middle Name:
Last Name:STELMAN
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 1:112 QUARRY RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4816
Mailing Address - Country:US
Mailing Address - Phone:203-372-4065
Mailing Address - Fax:203-372-1644
Practice Address - Street 1:112 QUARRY RD
Practice Address - Street 2:SUITE 120
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4816
Practice Address - Country:US
Practice Address - Phone:203-372-4065
Practice Address - Fax:203-372-1644
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039171207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001391713Medicaid
CTH37049Medicare UPIN
CT001391713Medicaid