Provider Demographics
NPI:1881158749
Name:MILES, DREW STEPHEN (FNP-C)
Entity type:Individual
Prefix:MR
First Name:DREW
Middle Name:STEPHEN
Last Name:MILES
Suffix:
Gender:M
Credentials:FNP-C
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Mailing Address - Street 1:29992 NORTHWESTERN HWY STE C
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3292
Mailing Address - Country:US
Mailing Address - Phone:248-851-1423
Mailing Address - Fax:248-851-5319
Practice Address - Street 1:31157 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-0996
Practice Address - Country:US
Practice Address - Phone:248-336-0123
Practice Address - Fax:248-268-1523
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-24
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704306900363LF0000X
MIF11180493363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily