Provider Demographics
NPI:1821194861
Name:MILAD, ANIS A (MD)
Entity Type:Individual
Prefix:
First Name:ANIS
Middle Name:A
Last Name:MILAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:43200 DEQUINDRE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1707
Mailing Address - Country:US
Mailing Address - Phone:586-799-4350
Mailing Address - Fax:586-799-4279
Practice Address - Street 1:4550 INVESTMENT DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098
Practice Address - Country:US
Practice Address - Phone:248-267-5040
Practice Address - Fax:248-267-5041
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301028599207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P41160OtherBCN
C2291OtherMCARE
1606319701OtherBCBSM
B44649Medicare UPIN
0P01590Medicare ID - Type UnspecifiedGROUP
C2291OtherMCARE