Organization
MILAM PROFESSIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS R MILAM MD (PRESIDENT)
(910) 792-1001
Entity
Organization
Contact information
Practice address
5429 WRIGHTSVILLE AVE, WILMINGTON, NC 28403-6513
(910) 792-1001
Mailing address
5429 WRIGHTSVILLE AVE, WILMINGTON, NC 28403-6513
(910) 792-1001
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
9901262
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016YR
BCBS
—
05
—
8913027
—
NC
01
—
DG2340
RAILROAD MEDICARE
—
Enumeration date
12/06/2005
Last updated
01/02/2010
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