Provider Demographics
NPI:1851404214
Name:MILLET, PHILIP DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:DANIEL
Last Name:MILLET
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 1:2 JOHNNY MERCER BLVD
Mailing Address - Street 2:APT. 1102
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-3329
Mailing Address - Country:US
Mailing Address - Phone:912-898-4047
Mailing Address - Fax:
Practice Address - Street 1:143 CANAL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-6007
Practice Address - Country:US
Practice Address - Phone:912-748-4527
Practice Address - Fax:912-748-9016
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058077208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics