Provider Demographics
NPI:1548257744
Name:MILAN, MALINA K (MD)
Entity type:Individual
Prefix:DR
First Name:MALINA
Middle Name:K
Last Name:MILAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3 CANAVAN CIR
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-1143
Mailing Address - Country:US
Mailing Address - Phone:781-449-0639
Mailing Address - Fax:
Practice Address - Street 1:25 BOYLSTON ST
Practice Address - Street 2:SUITE 204
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-1715
Practice Address - Country:US
Practice Address - Phone:617-754-0400
Practice Address - Fax:617-754-0425
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA202786207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA202786OtherTUFTS
MAMIJ23089OtherBLUE CROSS BLUE SHIELD
MA04-03462OtherUNITED HEALTHCARE
MA69902OtherHARVARD PILGRIM
MD2450382OtherAETNA
MAB10477101OtherCIGNA
MAMIJ23089OtherBLUE CROSS BLUE SHIELD
MAA31472Medicare ID - Type UnspecifiedMEDICARE