MEDICARE: DR. JAMES T. MILAM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	0101048458	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	323929	OTHER	VA	ANTHEM

General Provider Information

NPI Number	:	1275536567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES T. MILAM M.D.

Provider Business Mailing Address
First Line	:	110 EXCHANGE ST
Second Line	:	STE F
City	:	DANVILLE
State	:	VA
Zip	:	24541-3500
Country	:	US
Telephone Number	:	434-791-1562
Fax Number	:	434-791-3776

Provider Business Practice Location Address
First Line	:	110 EXCHANGE ST
Second Line	:	STE F
City	:	DANVILLE
State	:	VA
Zip	:	24541-3500
Country	:	US
Telephone Number	:	434-791-1562
Fax Number	:	434-791-3776

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	10/24/2011

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