Organization
P. DUDLEY GILES, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
P. DUDLEY GILES MD (OWNER/PHYSICIAN)
(772) 546-3223
Entity
Organization
Contact information
Practice address
323 SE OSCEOLA ST, STUART, FL 34994-2227
(772) 546-3223
(772) 220-1168
Mailing address
323 SE OSCEOLA ST, STUART, FL 34994-2227
(772) 546-3223
(772) 220-1168
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME0083459
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57715
BLUE CROSS BLUE SHIELD
FL
01
—
P00039155
RAILROAD MEDICARE
FL
Enumeration date
04/06/2010
Last updated
04/06/2010
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