Individual
DAVID ANTHONY MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8701 BROADWAY # C-124, MERRILLVILLE, IN 46410-7035
(219) 738-4929
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(571) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209001167
IL
367500000X
Certified Registered Nurse Anesthetist
28116051A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200115520
—
IN
Enumeration date
07/04/2006
Last updated
11/10/2023
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