Provider Demographics
NPI:1801527379
Name:MILLIE MEDICAL GROUP, P.C.
Entity type:Organization
Organization Name:MILLIE MEDICAL GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, MILLIE, INC.
Authorized Official - Prefix:MS
Authorized Official - First Name:ANUBHUTI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-451-8763
Mailing Address - Street 1:321 PAGE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5646
Mailing Address - Country:US
Mailing Address - Phone:312-451-8763
Mailing Address - Fax:
Practice Address - Street 1:2999 REGENT ST STE 524
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2120
Practice Address - Country:US
Practice Address - Phone:312-451-8763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty