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General NPI Number Information
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NPI Number | 1659787166
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Entity Type | Organization
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Legal Business Name | SHELI MILAM MD PA
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Dates
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Enumeration Date | 07/03/2014
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Last Update Date | 07/03/2014
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Provider Practice Location Address
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Address Line | 1001 N HALSTEAD RD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3121
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Country | US
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Telephone | 228-861-8658
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 N HALSTEAD RD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3121
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Country | US
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Telephone | 228-861-8658
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHELI MILAM
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Credential |
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Telephone | 228-861-8658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 16922
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License Number State | MS
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