Provider Demographics
NPI:1619523628
Name:MILLIGAN, STEVEN (PA-C)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:MILLIGAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 CANNONBALL RUN APT 206
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7296
Mailing Address - Country:US
Mailing Address - Phone:954-802-1983
Mailing Address - Fax:
Practice Address - Street 1:502 MCKNIGHT DR
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-7050
Practice Address - Country:US
Practice Address - Phone:919-803-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09035363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant