Basic Information
| Provider Information | |||||||||
| NPI: | 1215906607 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLS | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNC SCHOOL OF MEDICINE | ||||||||
| Address2: | 231 MACNIDER -- CB #7225 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199662504 | ||||||||
| FaxNumber: | 9199663852 | ||||||||
| Practice Location | |||||||||
| Address1: | UNC SCHOOL OF MEDICINE | ||||||||
| Address2: | 231 MACNIDER -- CB #7225 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199662504 | ||||||||
| FaxNumber: | 9199663852 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2006 | ||||||||
| LastUpdateDate: | 01/22/2009 | ||||||||
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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 | 208000000X | D0060461 | MD | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0204X | 2008-00312 | NC | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 402877500 | 05 | MD | MEDICAID | 75859901 | 01 | MD | BLUE SHIELD | OTHER |