Provider Demographics
NPI:1619904570
Name:UNAKA INTERNAL MEDICINE, LLC
Entity Type:Organization
Organization Name:UNAKA INTERNAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:G
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:II
Authorized Official - Credentials:DO
Authorized Official - Phone:423-735-4160
Mailing Address - Street 1:500 LOVE STREET
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650
Mailing Address - Country:US
Mailing Address - Phone:423-735-4160
Mailing Address - Fax:423-735-4159
Practice Address - Street 1:500 LOVE ST
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650
Practice Address - Country:US
Practice Address - Phone:423-735-4160
Practice Address - Fax:423-735-4159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO0000001740207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty