Provider Demographics
NPI:1760447791
Name:MILLWARD, PETER A (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:A
Last Name:MILLWARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17851 LOCHERBIE AVE
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4162
Mailing Address - Country:US
Mailing Address - Phone:248-930-4146
Mailing Address - Fax:
Practice Address - Street 1:3601 WEST THIRTEEN MILE ROAD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6769
Practice Address - Country:US
Practice Address - Phone:248-898-8013
Practice Address - Fax:248-898-3398
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301093189207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine