Provider Demographics
NPI:1588629166
Name:MILROY, STEPHEN KIRBY (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:KIRBY
Last Name:MILROY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3100 MCCORKLE AVE SE
Mailing Address - Street 2:STE 809
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1223
Mailing Address - Country:US
Mailing Address - Phone:304-345-0280
Mailing Address - Fax:304-346-9727
Practice Address - Street 1:3100 MCCORKLE AVE SE
Practice Address - Street 2:STE 809
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1223
Practice Address - Country:US
Practice Address - Phone:304-345-0280
Practice Address - Fax:304-346-9727
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2008-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV09883207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
550571386OtherCIGNA
0004242092OtherAETNA
001719615OtherMT STATE BCBS
2502480C2OtherOPTIMUM CHOICE
550571386OtherUNITED HEALTHCARE
550571386OtherUNICARE
WV550571386OtherACORDIA
550571386OtherAARP
550571386OtherBANKERS LIFE
550571386OtherUNITED AMERICAN
550571386OtherAAG PEABODY
550571386OtherCHA HEALTH
550571386OtherAAG
WV0070246000Medicaid
250248ML2OtherMAMSI
14208OtherCARELINK
WV0070246000Medicaid
WV550571386OtherACORDIA