Provider Demographics
NPI:1740507433
Name:LUM, MILTON (MD)
Entity type:Individual
Prefix:
First Name:MILTON
Middle Name:
Last Name:LUM
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 1:12502 WILLOWBROOK RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-6491
Mailing Address - Country:US
Mailing Address - Phone:301-724-8847
Mailing Address - Fax:
Practice Address - Street 1:12502 WILLOWBROOK RD
Practice Address - Street 2:SUITE 500
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-6491
Practice Address - Country:US
Practice Address - Phone:301-724-8847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPENDING208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery