Individual
MILES A SIMMONS
Active
Individual
MILES A SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
012801
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003576
ANTNEM
—
05
—
234080099
—
ME
01
—
78246
CIGNA
—
01
—
E004219
TRICARE
—
Enumeration date
09/08/2006
Last updated
09/25/2013
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