Provider Demographics
NPI:1760577548
Name:MCPHERSON, MILTON L (MD)
Entity Type:Individual
Prefix:
First Name:MILTON
Middle Name:L
Last Name:MCPHERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 641057
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15264-1057
Mailing Address - Country:US
Mailing Address - Phone:800-655-2656
Mailing Address - Fax:412-822-7411
Practice Address - Street 1:300 W 27TH ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3075
Practice Address - Country:US
Practice Address - Phone:910-671-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034767207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA249845OtherANTHEM
NC8958133Medicaid
VA010372801Medicaid
VA4503631OtherAETNA
VA1486303OtherCIGNA
NC58133OtherBCBS NC
VA68299OtherSOUTHERN HEALTH CARENET
VA1446496OtherAETNA
VA484793OtherSOUTHERN HEALTH
VA1486303OtherCIGNA
BO8198Medicare UPIN
VA4503631OtherAETNA