Provider Demographics
NPI:1265418750
Name:MIES, ANNETTE N (MD)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:N
Last Name:MIES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:17 EXCHANGE ST W
Mailing Address - Street 2:NUMBER 622
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-1045
Mailing Address - Country:US
Mailing Address - Phone:651-227-9141
Mailing Address - Fax:651-265-6772
Practice Address - Street 1:1655 BEAM AVE
Practice Address - Street 2:NUMBER 102
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1163
Practice Address - Country:US
Practice Address - Phone:651-227-9141
Practice Address - Fax:651-265-6772
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2017-01-09
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Provider Licenses
StateLicense IDTaxonomies
MN29149207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
457R0MIOtherBCBS
MN207587300Medicaid
23210OtherARAZ
960980641010OtherPREICH PROVIDER NUMBER
160002345OtherMETRAHEALTH MEDICARE
34547300OtherWISCONSIN MA
HP13975OtherEMHD
P00135294OtherRR MEDICARE
106064C280OtherUCARE
207587300OtherMN MEDICAL ASSISTANCE
0703919OtherMEDICA CHOICE
960980641010OtherPREFERRED ONE
960980641010OtherPEAK PROVIDER NUMBER
960980641010OtherPREFERRED ONE