Organization
MILES P LIGHT MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILES P LIGHT MD (PHYSICIAN PRESIDENT)
(989) 790-9460
Entity
Organization
Contact information
Practice address
3150 HALLMARK CT, STE #3, SAGINAW, MI 48603-2173
(989) 790-9460
(989) 790-9468
Mailing address
3150 HALLMARK CT, STE #3, SAGINAW, MI 48603-2173
(989) 790-9460
(989) 790-9468
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301066541
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1107301291
BLUE CROSS BLUE SHIELD
—
05
—
3407348
—
MI
01
—
51L00510
CIGNA
—
Enumeration date
10/04/2006
Last updated
11/30/2009
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