Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 0101238555 | VA |
N | 207ND0101X | MOHS-Micrographic Surgeon | 35.121284 | OH |
NPI | 1003879495 |
---|---|
Provider Name | Dr. Anis Miladi |
First Address | Chesapeake, VA 23322-3615 |
Second Address | Portsmouth, VA 23708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 05/02/2019 |