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General NPI Number Information
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NPI Number | 1679718720
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Entity Type | Organization
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Legal Business Name | MILES MEDICAL GROUP LLC
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 11111 NALL AVE STE 218
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City | LEAWOOD
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State | KS
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Zip | 66211-1695
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Country | US
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Telephone | 913-261-9812
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Fax | 816-608-2805
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Provider Business Mailing Address
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Address Line | 11111 NALL AVE STE 218
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City | LEAWOOD
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State | KS
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Zip | 66211-1695
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Country | US
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Telephone | 913-261-9812
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Fax | 816-608-2805
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHYNDA F. MILES
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Credential | MD
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Telephone | 913-261-9812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2002018384
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License Number State | MO
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