Provider Demographics
NPI:1023282704
Name:MILETIC, MICHAEL JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:MILETIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N OLD WOODWARD AVE
Mailing Address - Street 2:SUITE # 201
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-3855
Mailing Address - Country:US
Mailing Address - Phone:248-593-8540
Mailing Address - Fax:248-593-8542
Practice Address - Street 1:620 N OLD WOODWARD AVE
Practice Address - Street 2:SUITE # 201
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-3855
Practice Address - Country:US
Practice Address - Phone:248-593-8540
Practice Address - Fax:248-593-8542
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301048329173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine