Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 01037452A | IN |
N | 207XS0106X | Orthopaedic Hand Surgeon | 01037452A | IN |
N | 2086S0129X | Vascular Surgeon | 01037452 | IN |
NPI | 1134138175 |
---|---|
Provider Name | Dr. Alexander David Mih |
First Address | Chanute, KS 66720-1928 |
Second Address | Chanute, KS 66720-1928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 28/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000083018 | ANTHEM HEALTH PLAN (01) | |
04-38560 | STATE LICENSE (01) | KS |
100347890 | (05) | IN |
3192469001 | CIGNA (01) | |
E13622 | (02) |