Individual
SUSAN A MIKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
657 N TOWN CENTER DR, LAS VEGAS, NV 89144-6367
(702) 233-7200
Mailing address
1500 MARBELLA RIDGE CT, LAS VEGAS, NV 89117-1488
(702) 254-2720
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1212
NV
207R00000X
Internal Medicine Physician
1212
NV
208000000X
Pediatrics Physician
Primary
1212
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020537
—
AZ
05
—
100505930
—
NV
01
—
AZ0201750
AZ BC/BS
AZ
Enumeration date
04/11/2006
Last updated
01/20/2010
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