Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 9319 | NV |
NPI | 1144208455 |
---|---|
Provider Name | Dr. Michael Miao |
First Address | Las Vegas, NV 89121-3609 |
Second Address | Las Vegas, NV 89121-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2006 |
Last Update Date | 11/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200037695 | R.R. MEDICARE (01) | |
2018404 | (05) | NV |
7999278 | AETNA (01) | |
G40848 | (02) | |
NV2943 | BXBS (01) |