Provider Demographics
NPI:1720475734
Name:MCMILLAN, JANICE (MD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:
Last Name:MCMILLAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 FAIR RIDGE DR STE 218
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2945
Mailing Address - Country:US
Mailing Address - Phone:703-870-3750
Mailing Address - Fax:
Practice Address - Street 1:3903 FAIR RIDGE DR STE 218
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2945
Practice Address - Country:US
Practice Address - Phone:703-870-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101266682207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine