Michelle Renee Milner, MD
Individual provider Active NPI Family Medicine Physician · Fairfield, CA
NPI 1174699110 · NPPES record last updated Jun 13, 2023
Key facts
- NPI
- 1174699110
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0101238176 (VA)
- Practice address
- 101 Bodin Cir
Fairfield, CA 94535-1809 - Phone
- (707) 423-5423
- NPI assigned
- Nov 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101238176 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Malcolm Grow Medical Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101238176 | VA | Yes |
Addresses
Primary practice location
101 Bodin Cir
Fairfield, CA 94535-1809
Mailing address
101 Bodin Cir
Fairfield, CA 94535-1809
Phone (707) 423-5423
Other providers in Fairfield, CA
- Larry Joe Miller
- Millicent LLC
- Jody Mills
- Veronica Millsap
- Elizabeth Milne
- Shane Caitlyn del Fierro Minas
- Samantha Marie Miner
- Courtney M Minor
- Martin A Miranda
- Timothy Miranda
All providers in Fairfield, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.