Provider Demographics
NPI:1639152093
Name:AUSTER, MILES S (MD)
Entity Type:Individual
Prefix:DR
First Name:MILES
Middle Name:S
Last Name:AUSTER
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 1:1777 AXTELL DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4404
Mailing Address - Country:US
Mailing Address - Phone:248-649-2626
Mailing Address - Fax:248-649-5284
Practice Address - Street 1:1777 AXTELL DR
Practice Address - Street 2:SUITE 205
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4404
Practice Address - Country:US
Practice Address - Phone:248-649-2626
Practice Address - Fax:248-649-5284
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301028908207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B44539Medicare UPIN
3633607Medicare ID - Type Unspecified