Provider Demographics
NPI:1750461729
Name:TRENT MILLS, CHEREE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHEREE
Middle Name:
Last Name:TRENT MILLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHEREE
Other - Middle Name:ANN
Other - Last Name:TRENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 11326
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-0126
Mailing Address - Country:US
Mailing Address - Phone:314-692-0111
Mailing Address - Fax:314-692-0126
Practice Address - Street 1:8515 DELMAR BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2168
Practice Address - Country:US
Practice Address - Phone:314-692-0111
Practice Address - Fax:314-692-0126
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1K44207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202733812Medicaid
MO840201081Medicare PIN
MOE22211Medicare UPIN