Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | 5101022208 | MI |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101026170 | MI |
NPI | 1063867356 |
---|---|
Provider Name | Dr. Miles Ross Neumann |
First Address | Southfield, MI 48034-7648 |
Second Address | Southfield, MI 48034-7648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2016 |
Last Update Date | 08/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5101022208 | MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS (01) | MI |
5101026170 | MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS (01) | MI |