Provider Demographics
NPI:1124150636
Name:SCHILLER, HERBERT MILES (MD)
Entity type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:MILES
Last Name:SCHILLER
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 1:2851 KENSINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-5709
Mailing Address - Country:US
Mailing Address - Phone:336-724-9607
Mailing Address - Fax:
Practice Address - Street 1:2851 KENSINGTON RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5709
Practice Address - Country:US
Practice Address - Phone:336-724-9607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16009207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG50362Medicare UPIN