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General NPI Number Information
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NPI Number | 1124343876
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Entity Type | Organization
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Legal Business Name | P. DUDLEY GILES, MD, PA
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Dates
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Enumeration Date | 04/06/2010
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Last Update Date | 04/06/2010
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Provider Practice Location Address
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Address Line | 323 SE OSCEOLA ST
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City | STUART
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State | FL
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Zip | 34994-2227
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Country | US
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Telephone | 772-546-3223
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Fax | 772-220-1168
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Provider Business Mailing Address
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Address Line | 323 SE OSCEOLA ST
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City | STUART
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State | FL
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Zip | 34994-2227
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Country | US
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Telephone | 772-546-3223
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Fax | 772-220-1168
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | P. DUDLEY GILES
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Credential | MD
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Telephone | 772-546-3223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME0083459
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License Number State | FL
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