Provider Demographics
NPI:1750453783
Name:MIALE, THOMAS DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DAVID
Last Name:MIALE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 50642
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950-0642
Mailing Address - Country:US
Mailing Address - Phone:865-531-2078
Mailing Address - Fax:865-531-2078
Practice Address - Street 1:2001 LAUREL AVE STE N401
Practice Address - Street 2:NEWLAND PROFESSIONAL BUILDING FORT SANDERS REGIONAL MC
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1810
Practice Address - Country:US
Practice Address - Phone:865-531-2078
Practice Address - Fax:865-531-2078
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TN191022080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB59061Medicare UPIN