Provider Demographics
NPI:1215906607
Name:MILLS, WILLIAM A JR (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:MILLS
Suffix:JR
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:UNC SCHOOL OF MEDICINE
Mailing Address - Street 2:231 MACNIDER -- CB #7225
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:919-966-2504
Mailing Address - Fax:919-966-3852
Practice Address - Street 1:UNC SCHOOL OF MEDICINE
Practice Address - Street 2:231 MACNIDER -- CB #7225
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-2504
Practice Address - Fax:919-966-3852
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060461208000000X
NC2008-003122080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402877500Medicaid
MD75859901OtherBLUE SHIELD
MD402877500Medicaid
H98732Medicare UPIN