Provider Demographics
NPI:1275536567
Name:MILAM, JAMES T (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:T
Last Name:MILAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:110 EXCHANGE ST
Mailing Address - Street 2:STE F
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-3500
Mailing Address - Country:US
Mailing Address - Phone:434-791-1562
Mailing Address - Fax:434-791-3776
Practice Address - Street 1:110 EXCHANGE ST
Practice Address - Street 2:STE F
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-3500
Practice Address - Country:US
Practice Address - Phone:434-791-1562
Practice Address - Fax:434-791-3776
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101048458207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5639689Medicaid
VA323929OtherANTHEM
VA323929OtherANTHEM
VA5639689Medicaid
VAF43231Medicare UPIN
080007044Medicare PIN