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Individual

CHARLES A MILEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2780 FREDERICA ST, OWENSBORO, KY 42301-5442
(270) 926-4100
(270) 648-4678
Mailing address
2780 FREDERICA ST, OWENSBORO, KY 42301-5442
(270) 926-4100
(270) 648-4678

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
27488
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000052290
ANTHEM
KY
01
200022273
RAILROAD MEDICARE
KY
05
64274889
KY
01
K005560
TRICARE
KY
Enumeration date
05/24/2005
Last updated
10/14/2024
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