Provider Demographics
NPI:1881024529
Name:MILHOUS, MARIA D (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:MILHOUS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:D
Other - Last Name:GILLIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8201 ATLEE RD STE D
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-1815
Mailing Address - Country:US
Mailing Address - Phone:804-569-1787
Mailing Address - Fax:804-569-9787
Practice Address - Street 1:8201 ATLEE RD STE D
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116
Practice Address - Country:US
Practice Address - Phone:804-569-1787
Practice Address - Fax:804-569-9787
Is Sole Proprietor?:No
Enumeration Date:2013-11-15
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 28831208100000X
VA2305208126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05954OtherGROUP MEDICARE PTAN
VA1881024529OtherMEDICAID QMB ONLY
VAQ55169AMedicare PIN