Healthcare Provider Details

I. General information

NPI: 1457265571
Provider Name (Legal Business Name): MILESWELL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 GRACE FARM LN
BUFORD GA
30519-0100
US

IV. Provider business mailing address

8735 DUNWOODY PLACE STE R
ATLANTA GA
30350
US

V. Phone/Fax

Practice location:
  • Phone: 631-278-1715
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. NATALIA MILES
Title or Position: OWNER
Credential:
Phone: 631-278-1715