Provider Demographics
NPI:1972285039
Name:MILES, LINWOOD
Entity Type:Individual
Prefix:
First Name:LINWOOD
Middle Name:
Last Name:MILES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 EDEN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-7299
Mailing Address - Country:US
Mailing Address - Phone:301-282-6967
Mailing Address - Fax:
Practice Address - Street 1:2505 12TH PL SE APT 301
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2939
Practice Address - Country:US
Practice Address - Phone:202-577-1918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant