Provider Demographics
NPI:1154674810
Name:MILES, SHARNETTE (DPM)
Entity Type:Individual
Prefix:
First Name:SHARNETTE
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:225-761-5290
Practice Address - Street 1:9001 SUMMA AVE
Practice Address - Street 2:OCHSNER MEDICAL CENTER BATON ROUGE
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3726
Practice Address - Country:US
Practice Address - Phone:225-761-5500
Practice Address - Fax:225-761-5290
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADPM.200056213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2320378Medicaid
MS05331008Medicaid
LA2320378Medicaid