=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689651424
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMABILE MILANO MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2005
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2401 S KANAWHA ST
-----------------------------------------------------
City | BECKLEY
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25801-6905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-253-8294
-----------------------------------------------------
Fax | 304-253-8295
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2401 S KANAWHA ST
-----------------------------------------------------
City | BECKLEY
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25801-6905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-253-8294
-----------------------------------------------------
Fax | 304-253-8295
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | 12069
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------