Provider Demographics
NPI:1881771947
Name:MACMILLAN, MARGARET L (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:L
Last Name:MACMILLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE, MMC 366
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-2778
Mailing Address - Fax:
Practice Address - Street 1:2450 RIVERSIDE AVE SE
Practice Address - Street 2:EAST BUILDING JOURNEY CLINIC 9E
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454
Practice Address - Country:US
Practice Address - Phone:612-365-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN415022080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
123582OtherUCARE
MNHP28790OtherHEALTHPARTNERS
IA0517722Medicaid
1020134OtherPREFERREDONE
MN20G22MAOtherBLUE CROSS BLUE SHIELD
MT0052234Medicaid
MN36-00058OtherMEDICA CHOICE
36-12094OtherMEDICA PRIMARY
MN214519700Medicaid
WI32592500Medicaid
744864OtherARAZ
36-12094OtherMEDICA PRIMARY
MT0052234Medicaid
WI32592500Medicaid