Theodore Miko is a Specialist in Lilburn, Georgia. Theodore Miko practices all healthcare services and medical treatments related to Specialist. The NPI Number for Theodore Miko is 1932216785. The last update date is 2007-07-08.
Theodore Miko's current location address is 4391 Fallowfield Ln Sw, Lilburn, Georgia. You can contact this provider via phone number 6783804081 and fax number 6783804348. The mailing address for Theodore Miko is 4391 Fallowfield Ln Sw, Lilburn, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Theodore Miko |
|---|---|
| Address | 4391 Fallowfield Ln Sw, Lilburn, Georgia |
| Phone Number | 6783804081 |
| Fax Number | 6783804348 |
| Sole Proprietor | Y |
| Credentials | D.O. |
NPI Number Detail
| NPI Number | 1932216785 |
|---|---|
| Provider Enumeration Date | 2006-08-25 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4391 Fallowfield Ln Sw |
|---|---|
| City | Lilburn |
| State | Georgia (GA) |
| Post Code | 300477405 |
| Phone Number | 6783804081 |
| Fax Number | 6783804348 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 44966 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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What is the Theodore Miko's unique identification number?
The Theodore Miko has been assigned the NPI (National Provider Identifier) Number 1932216785 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Theodore Miko located?
The Theodore Miko is located at 4391 Fallowfield Ln Sw, Lilburn, GA 300477405.
What is the Theodore Miko's specialty and taxonomy code?
The Theodore Miko's specialty is Specialist, and the corresponding taxonomy code is 174400000X.
On what date did the Theodore Miko receive its 1932216785 assignment from the Centers for Medicare & Medicaid Services?
The Theodore Miko was assigned its 1932216785 by the Centers for Medicare & Medicaid Services on 2006-08-25.
As of what date were the Theodore Miko's details last updated?
The information pertaining to the Theodore Miko, including its address, specialty, and other details, was most recently updated on 2007-07-08.