Individual
DR. WAYNE B MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 E WOODHURST DR, K-300, SPRINGFIELD, MO 65804-4257
(417) 887-1188
(417) 887-1837
Mailing address
1200 E WOODHURST DR, K-300, SPRINGFIELD, MO 65804-4257
(417) 887-1188
(417) 887-1837
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R5876
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20479
BLUE CROSS BLUE SHIELD
MO
01
—
667282
UNITED HEALTHCARE
MO
Enumeration date
07/15/2005
Last updated
07/08/2007
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