Millennium Medical P C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R8H32 Issued in MO

Legal business name

MILLENNIUM MEDICAL P C

Practice address

1153 E Gannon Dr
Festus, MO 63028-2611

Phone

(636) 931-3667

NPI assigned

Nov 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Solomon Noguera, M.D.

Title

Ceo

Phone

(636) 931-3667

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278892800000",
    "number": "1740460211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 E GANNON DR",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282611",
            "telephone_number": "636-931-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 E GANNON DR",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282611",
            "telephone_number": "636-931-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM MEDICAL P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2010-07-12",
        "status": "A",
        "authorized_official_last_name": "NOGUERA",
        "authorized_official_first_name": "SOLOMON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "636-931-3667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R8H32",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Festus, MO
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• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.