Provider Demographics
NPI:1639465479
Name:MILLWARD, CYNTHIA JAPHET (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JAPHET
Last Name:MILLWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:FLORENCE
Other - Last Name:JAPHET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:611 E STAR CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-6704
Mailing Address - Country:US
Mailing Address - Phone:970-249-4321
Mailing Address - Fax:
Practice Address - Street 1:611 E STAR CT
Practice Address - Street 2:SUITE A
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-6704
Practice Address - Country:US
Practice Address - Phone:970-249-4321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4050208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery