Healthcare Provider Details

I. General information

NPI: 1053127761
Provider Name (Legal Business Name): SAMANTHA MILEWSKI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2024
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 W CHANDLER BLVD STE B13
CHANDLER AZ
85226-3681
US

IV. Provider business mailing address

5505 W CHANDLER BLVD STE B13
CHANDLER AZ
85226-3681
US

V. Phone/Fax

Practice location:
  • Phone: 480-361-4780
  • Fax: 480-361-4781
Mailing address:
  • Phone: 480-361-4780
  • Fax: 480-361-4781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11282
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: