Individual
MR. MILES EDWARD DEWAYNE HAIRSTON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
601 N ELM ST, HIGH POINT, NC 27262-4331
(336) 878-6000
Mailing address
PROVIDER ENROLLMENT, 100 KIMEL FOREST DRIVE, WINSTON SALEM, NC 27103-6074
(336) 713-0947
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
5019016
NC
363L00000X
Nurse Practitioner
Primary
5019016
NC
Other
Enumeration date
10/09/2023
Last updated
12/07/2023
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