Provider Demographics
NPI:1538175799
Name:MILNER, MICHAEL MARK (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MARK
Last Name:MILNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33165 SOLON RD
Mailing Address - Street 2:STE 100
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2863
Mailing Address - Country:US
Mailing Address - Phone:440-349-5575
Mailing Address - Fax:440-249-5552
Practice Address - Street 1:33165 SOLON RD
Practice Address - Street 2:STE 100
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2863
Practice Address - Country:US
Practice Address - Phone:440-349-5575
Practice Address - Fax:440-249-5552
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35053491207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0736216Medicaid
OHM10594952Medicare ID - Type Unspecified
OH0736216Medicaid