MEDICARE: MICHAEL J MIEDLER MD

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
1	207RI0200X	Infectious Disease Physician	37765	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00044634	OTHER	KY	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548261837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL J MIEDLER MD

Provider Business Mailing Address
First Line	:	1720 NICHOLASVILLE RD
Second Line	:	SUITE 602
City	:	LEXINGTON
State	:	KY
Zip	:	40503-1475
Country	:	US
Telephone Number	:	859-277-4005
Fax Number	:	859-278-2507

Provider Business Practice Location Address
First Line	:	1720 NICHOLASVILLE RD
Second Line	:	SUITE 602
City	:	LEXINGTON
State	:	KY
Zip	:	40503-1475
Country	:	US
Telephone Number	:	859-277-4005
Fax Number	:	859-278-2507

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	03/04/2008

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