Individual
DR. MICHAEL MIKOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
SC16144
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161443
—
SC
01
—
571020809012
BCBS
SC
01
—
571020809058
TRICARE
SC
01
—
P00102686
RR MEDICARE
SC
01
—
P00834833
RAILROAD MEDICARE ID-RSFPN
SC
Enumeration date
05/16/2006
Last updated
10/20/2015
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