Individual
SAMUEL MILHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2318 GRAVELLY BEACH LOOP NW, OLYMPIA, WA 98502-8837
(360) 866-0256
Mailing address
2318 GRAVELLY BEACH LOOP NW, OLYMPIA, WA 98502-8837
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
MD 00010492
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD 00010492
WASHINGTON STATE MEDICAL LICENSE
WA
Enumeration date
01/19/2011
Last updated
01/19/2011
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