Provider Demographics
NPI:1194751644
Name:MILTEER, REGINA M (MD)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:M
Last Name:MILTEER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8602 EAGLE GLEN TER
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039-2679
Mailing Address - Country:US
Mailing Address - Phone:703-643-1910
Mailing Address - Fax:703-643-0346
Practice Address - Street 1:10777 MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6903
Practice Address - Country:US
Practice Address - Phone:703-246-6015
Practice Address - Fax:703-643-0346
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101034000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB95072Medicare UPIN