Provider Demographics
NPI:1598798654
Name:STRUTIN, MILLARD DESMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:MILLARD
Middle Name:DESMOND
Last Name:STRUTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:119 DOGWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4849
Mailing Address - Country:US
Mailing Address - Phone:973-328-1414
Mailing Address - Fax:973-361-1085
Practice Address - Street 1:121 CENTER GROVE RD
Practice Address - Street 2:NW SURGICAL
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-4453
Practice Address - Country:US
Practice Address - Phone:973-328-1414
Practice Address - Fax:973-361-1085
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2020-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA042257208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery