Provider Demographics
NPI:1992702567
Name:MILLIKEN MEDICAL PLLC
Entity type:Organization
Organization Name:MILLIKEN MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:SEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:231-932-4880
Mailing Address - Street 1:224 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2342
Mailing Address - Country:US
Mailing Address - Phone:231-935-0600
Mailing Address - Fax:231-935-0613
Practice Address - Street 1:224 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2342
Practice Address - Country:US
Practice Address - Phone:231-935-0600
Practice Address - Fax:231-935-0613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIOM85930207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B81016OtherBCBS
MI0B81016OtherBCBS