Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 0101048458 | VA |
NPI | 1275536567 |
---|---|
Provider Name | Dr. James T. Milam |
First Address | Danville, VA 24541-3500 |
Second Address | Danville, VA 24541-3500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 24/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
323929 | ANTHEM (01) | VA |
5639689 | (05) | VA |
F43231 | (02) | VA |