Provider Demographics
NPI:1851362636
Name:MILLO, CORINA M (MD)
Entity Type:Individual
Prefix:
First Name:CORINA
Middle Name:M
Last Name:MILLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:19650 CLUB HOUSE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MONTGOMRY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3039
Mailing Address - Country:US
Mailing Address - Phone:301-948-5700
Mailing Address - Fax:240-683-3612
Practice Address - Street 1:19650 CLUB HOUSE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MONTGOMRY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-3039
Practice Address - Country:US
Practice Address - Phone:301-948-5700
Practice Address - Fax:240-683-3612
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0063404207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDPENDINGMedicaid
PENDINGMedicare ID - Type Unspecified
MDPENDINGMedicaid