Basic Information
| Provider Information | |||||||||
| NPI: | 1063447449 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILGRIM | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | PAUL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 740177 | ||||||||
| Address2: | |||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334740177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617402900 | ||||||||
| FaxNumber: | 5614340598 | ||||||||
| Practice Location | |||||||||
| Address1: | 4675 LINTON BLVD | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334456615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614960808 | ||||||||
| FaxNumber: | 5614963728 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 01/19/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | ME0042323 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.