Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 42425 | KY |
Y | 207VX0201X | Gynecologic Oncologist | 51599 | TN |
NPI | 1306040852 |
---|---|
Provider Name | Michael R Milam |
First Address | Nashville, TN 37203-2131 |
Second Address | Nashville, TN 37203-2131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2007 |
Last Update Date | 20/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0722555 | MEDICARE FOUNDATION (01) | KY |
2009440202 | (05) | IN |
3726268000 | PASSPORT ADVANTAGE PCP (01) | KY |
3726272000 | PASSPORT ADVANTAGE SPECIALITY (01) | KY |
3726275000 | PASSPORT ADVANTAGE (01) | KY |
4173180 | BLUE CROSS-BLUE SHIELD (01) | TN |
50024848 | PASSPORT PCP (01) | KY |
50024852 | PASSPORT SPECIALITY (01) | KY |
50024855 | PASSPORT SPECIALITY (01) | KY |
7100072820 | (05) | KY |
7998973 | AETNA (01) | KY |
Q008295 | (05) | TN |