Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 18704 | SC |
NPI | 1073555207 |
---|---|
Provider Name | Gerald B Miele |
First Address | Florence, SC 29503-1905 |
Second Address | Florence, SC 29506-2616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 17/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
890644K | (05) | NC |
B41191 | (02) | SC |
T28994 | (05) | SC |