Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 27488 | KY |
NPI | 1013910819 |
---|---|
Provider Name | Charles A Milem |
First Address | Owensboro, KY 42303-1320 |
Second Address | Owensboro, KY 42303-1320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 14/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000052290 | ANTHEM (01) | KY |
200022273 | RAILROAD MEDICARE (01) | KY |
64274889 | (05) | KY |
F62367 | (02) | KY |
K005560 | TRICARE (01) | KY |