Provider Demographics
NPI:1962422444
Name:MILES, ERIK J (MD)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:J
Last Name:MILES
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:9735 KINCEY AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-9118
Mailing Address - Country:US
Mailing Address - Phone:704-896-5556
Mailing Address - Fax:704-896-5585
Practice Address - Street 1:9735 KINCEY AVE STE 104
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-9118
Practice Address - Country:US
Practice Address - Phone:704-896-5556
Practice Address - Fax:704-869-5585
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2016-03-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2007-00556208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2007-00556OtherMEDICAL LICENSE