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Individual

DR. MILES W TRUMBLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD PLLC

Contact information

Practice address
1420 PLAZA DR, STE 1A, PETOKSEY, MI 49770
(231) 487-3937
(231) 487-3939
Mailing address
1420 PLAZA DR, 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
180034077
PALMETTOGBA
MI
01
180B410190
BLUE SHIELD
05
3481120
MI
01
P54436
BCN
Enumeration date
04/27/2006
Last updated
07/25/2008
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