Provider Demographics
NPI:1558564716
Name:MILLICENT G. ZACHER, DO, PC
Entity Type:Organization
Organization Name:MILLICENT G. ZACHER, DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MILLICENT
Authorized Official - Middle Name:G
Authorized Official - Last Name:ZACHER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-642-1442
Mailing Address - Street 1:233 E LANCASTER AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2321
Mailing Address - Country:US
Mailing Address - Phone:610-642-1442
Mailing Address - Fax:610-642-1344
Practice Address - Street 1:233 E LANCASTER AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2321
Practice Address - Country:US
Practice Address - Phone:610-642-1442
Practice Address - Fax:610-642-1344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004380L207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1078035Medicare ID - Type Unspecified
PAC27709Medicare UPIN