Provider Demographics
NPI:1871882142
Name:MILES, MIMI CHANDLER (MD)
Entity type:Individual
Prefix:
First Name:MIMI
Middle Name:CHANDLER
Last Name:MILES
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF FAMILY MEDICINE
Mailing Address - Street 2:590 MANNING DRIVE,CB#7595
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7595
Mailing Address - Country:US
Mailing Address - Phone:919-966-3456
Mailing Address - Fax:919-966-6125
Practice Address - Street 1:DEPARTMENT OF FAMILY MEDICINE
Practice Address - Street 2:590 MANNING DRIVE,CB#7595
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7595
Practice Address - Country:US
Practice Address - Phone:919-966-3456
Practice Address - Fax:919-966-6125
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2016-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC158730207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine