Provider Demographics
NPI:1659155455
Name:MILLS, DONALD
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:MILLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24634 5 MILE RD STE 19
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-3667
Mailing Address - Country:US
Mailing Address - Phone:877-742-6833
Mailing Address - Fax:
Practice Address - Street 1:24634 5 MILE RD STE 19
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3667
Practice Address - Country:US
Practice Address - Phone:877-742-6833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health