Provider Demographics
NPI:1639173149
Name:MILES, ROBERT H (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:MILES
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:PO BOX 123130 DEPT 3130
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-4851
Mailing Address - Country:US
Mailing Address - Phone:504-301-2515
Mailing Address - Fax:504-301-2606
Practice Address - Street 1:2820 NAPOLEON AVE STE 750
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6985
Practice Address - Country:US
Practice Address - Phone:504-301-2515
Practice Address - Fax:504-301-2606
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD013704207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1337285Medicaid
LA1337285Medicaid
LA5K561Medicare ID - Type Unspecified