Physician Compare National (NPI:1851384457)

HEALTHCARE PROVIDER: MILES P LIGHT MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1851384457
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9931270824
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080620000102
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LIGHT
	Individual professional last name
Provider First Name	MILES
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	FAMILY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	FAMILY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	3150 HALLMARK CT
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 3
	Group Practice or individual's line 2 address
City	SAGINAW
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	486032173
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	230070
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	COVENANT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	231316
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HILLS & DALES GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	230077
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ST MARY'S OF MICHIGAN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y