Individual
MR. MICHAEL MATTHEW MILAM
Active
Individual
MR. MICHAEL MATTHEW MILAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.C.
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10423
AZ
363AS0400X
Surgical Physician Assistant
50-00-2337
OH
363AS0400X
Surgical Physician Assistant
PA60150118
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000377375
ANTHEM
OH
01
—
0264600
L&I AND CRIME VICTIMS
WA
01
—
0283MI
REGENCE
WA
05
—
1548250954
—
WA
05
—
200992
—
AZ
01
—
415536
WELLCARE
OH
01
—
P00726959
RAILROAD MEDICARE
OH
Enumeration date
10/26/2005
Last updated
11/22/2024
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