Provider Demographics
NPI:1023160983
Name:MILTEER, WARREN EUGENE SR (MD)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:EUGENE
Last Name:MILTEER
Suffix:SR
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:5239 CRAIGS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-4844
Mailing Address - Country:US
Mailing Address - Phone:502-361-2301
Mailing Address - Fax:502-368-7078
Practice Address - Street 1:1800 BLUEGRASS AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1130
Practice Address - Country:US
Practice Address - Phone:502-361-2301
Practice Address - Fax:502-368-7078
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY31777207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BO6559Medicare UPIN