Individual
ANGELO MIELE
Active
Individual
ANGELO MIELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036064705
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036064705
—
IL
01
—
920540
MEDICARE GROUP PTAN
IL
01
—
CA4748
MEDICARE GROUP RR PTAN
IL
01
—
F400137214
MEDICARE INDIVIDUAL PTAN
IL
01
—
P01328176
MEDICARE INDIVIDUAL RR PTAN
IL
Enumeration date
09/16/2006
Last updated
06/24/2016
Update your record
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