Provider Demographics
NPI:1912058595
Name:MILLEA, MAUREEN ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:ELIZABETH
Last Name:MILLEA
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 1:1510 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3033
Mailing Address - Country:US
Mailing Address - Phone:413-253-1512
Mailing Address - Fax:
Practice Address - Street 1:50 COLLEGE STREET
Practice Address - Street 2:PATTIE GROVES HEALTH CENTER, MOUNT HOLYOKE COLLEGE
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075
Practice Address - Country:US
Practice Address - Phone:413-538-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA47109207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine