Provider Demographics
NPI:1407145220
Name:MILAM, BENJAMIN MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:MICHAEL
Last Name:MILAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9399 CROWN CREST BLVD
Mailing Address - Street 2:STE 401
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8506
Mailing Address - Country:US
Mailing Address - Phone:720-274-2544
Mailing Address - Fax:720-274-2541
Practice Address - Street 1:9399 CROWN CREST BLVD
Practice Address - Street 2:STE 401
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8506
Practice Address - Country:US
Practice Address - Phone:720-274-2544
Practice Address - Fax:720-274-2541
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0056844207Y00000X
CO56844207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology