Provider Demographics
NPI:1720605660
Name:MILES, DEVIN (PHD)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:MILES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 UNION AVE APT 310
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1977
Mailing Address - Country:US
Mailing Address - Phone:304-627-4777
Mailing Address - Fax:
Practice Address - Street 1:401 N. BROADWAY
Practice Address - Street 2:WEINBERG BUILDING SUITE 1440
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231
Practice Address - Country:US
Practice Address - Phone:304-627-4777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program