Marshall Poulnot McMillan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

31334 Issued in NC

Practice address

9101 Monroe Rd
Suite 155
Charlotte, NC 28270-2442

Phone

(704) 384-1260

Fax

(704) 384-1289

NPI assigned

Sep 20, 2005

Last updated

Jan 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mmcmillan14667@direct.novanthealth.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1093701666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7840",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 MONROE RD",
            "address_2": "SUITE 155",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282702442",
            "telephone_number": "704-384-1260",
            "fax_number": "704-384-1289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "MARSHALL",
        "middle_name": "POULNOT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "31334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8957857",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124662",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MMCMILLAN14667@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "9101 Monroe Rd",
            "address_2": "Suite 155",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282702442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Edward Beman McMillan, MD
• Eleanor May McMillan, PT, DPT
• Jeanevra Lanise McMillan, LMFT
• Jessica McMillan
• Lakisha Lindale McMillan
• Patria Goodwin McMillan
• Patti P. McMillan, LPC
• Rahsan Demarcus McMillan, PT, DPT
• Marvin Terrell McMillar, LCSWA
• Colleen McMillen, NP

• Family Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.