Individual
ANNETTE N MIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1655 BEAM AVE, NUMBER 102, MAPLEWOOD, MN 55109-1163
(651) 227-9141
(651) 265-6772
Mailing address
17 EXCHANGE ST W, NUMBER 622, SAINT PAUL, MN 55102-1045
(651) 227-9141
(651) 265-6772
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
29149
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0703919
MEDICA CHOICE
—
01
—
106064C280
UCARE
—
01
—
160002345
METRAHEALTH MEDICARE
—
01
—
207587300
MN MEDICAL ASSISTANCE
—
05
—
207587300
—
MN
01
—
23210
ARAZ
—
01
—
34547300
WISCONSIN MA
—
01
—
457R0MI
BCBS
—
01
—
960980641010
PREICH PROVIDER NUMBER
—
01
—
HP13975
EMHD
—
01
—
P00135294
RR MEDICARE
—
Enumeration date
12/16/2005
Last updated
01/09/2017
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