Provider Demographics
NPI:1255896866
Name:TAKA, MILKA
Entity type:Individual
Prefix:
First Name:MILKA
Middle Name:
Last Name:TAKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 GIRARD ST APT 102
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-3319
Mailing Address - Country:US
Mailing Address - Phone:301-339-8382
Mailing Address - Fax:
Practice Address - Street 1:10801 LOCKWOOD DR STE 300
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1562
Practice Address - Country:US
Practice Address - Phone:301-681-0004
Practice Address - Fax:301-593-1981
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR204638364SF0001X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health