Healthcare Provider Details
I. General information
NPI: 1467463992
Provider Name (Legal Business Name): LESTER MICHAEL MILES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/10/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1160 VARNUM ST NE SUITE 306
WASHINGTON DC
20017-2107
US
IV. Provider business mailing address
1160 VARNUM ST NE SUITE 306
WASHINGTON DC
20017-2107
US
V. Phone/Fax
- Phone: 202-269-2011
- Fax: 202-269-2013
- Phone: 202-269-2011
- Fax: 202-269-2013
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | D0026024 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: