Organization
MILES W TRUMBLE MD PLLC
Active
Other names
Bear River Eye Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MILES W TRUMBLE MD (OWNER)
(231) 487-3937
Entity
Organization
Contact information
Practice address
1420 PLAZA DRIVE, STE 1A, PETOSKEY, MI 49770
(231) 487-3937
(231) 487-3939
Mailing address
1420 PLAZA DRIVE, STE 1A, PETOSKEY, MI 49770
(231) 487-3937
(231) 487-3939
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MT030207
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180B410190
BLUE SHIELD
MI
05
—
3481120
—
MI
01
—
P54436
BLUE CARE NETWORK
MI
Enumeration date
08/10/2007
Last updated
08/19/2008
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