Provider Demographics
NPI:1225297732
Name:DAVID MIELES MD LLC
Entity Type:Organization
Organization Name:DAVID MIELES MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MIELES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-563-7444
Mailing Address - Street 1:4570 REESE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-1177
Mailing Address - Country:US
Mailing Address - Phone:706-563-7444
Mailing Address - Fax:
Practice Address - Street 1:4570 REESE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-1177
Practice Address - Country:US
Practice Address - Phone:706-563-7444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0055688251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health