Provider Demographics
NPI:1447249156
Name:MILES, CURTIS R (MD)
Entity type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:R
Last Name:MILES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:531 ROSELANE ST NW STE 710
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6975
Mailing Address - Country:US
Mailing Address - Phone:678-331-3297
Mailing Address - Fax:678-581-7187
Practice Address - Street 1:1020 J L WHITE DR STE 160
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-4910
Practice Address - Country:US
Practice Address - Phone:706-692-0603
Practice Address - Fax:678-581-7109
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA025233207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000343098MMedicaid
GA1447249156OtherNPI NUMBER
GA000343098LMedicaid
GA000343098EMedicaid
GA90BDBMBMedicare ID - Type Unspecified
GA000343098LMedicaid
GA000343098EMedicaid