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NPI Code Detail

MEDICARE: DR. CHRISTINE MIYAKE M.D.

MEDICARE: DR. CHRISTINE MIYAKE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician37706IA
2207P00000XEmergency Medicine Physician242918NY
3207P00000XEmergency Medicine Physician26129NE
4207P00000XEmergency Medicine Physician15306NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
172417OTHERIAWELLMARK BCBS

General Provider Information

NPI Number : 1194833277
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINE MIYAKE M.D.
Provider Business Mailing Address
First Line : 500 N RAINBOW BLVD STE 203
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-1084
Country : US
Telephone Number : 702-259-1228
Fax Number :
Provider Business Practice Location Address
First Line : 500 N RAINBOW BLVD STE 203
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-1084
Country : US
Telephone Number : 702-259-1228
Fax Number : 402-559-9659
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2006
Last Update Date : 05/06/2021

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Directions to “ DR. CHRISTINE MIYAKE M.D.” Practice Location

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