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Dr. Ethan Andrew Miles, MD

Family Medicine in Fort Benning, GA. Individual provider (NPI-1).

NPI number1821177445
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1821177445
Entity type
Individual (NPI-1)
Name
Dr. Ethan Andrew Miles
Credential
MD
Sex
Male
Sole proprietor
Yes
Enumeration date
Nov 3, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineA90114CAYes

Practice location

Martin Army Community Hospital
Fort Benning, GA 31905

Phone 706-545-4340

Mailing address

1646 Wildwood Ave
Columbus, GA 31906-2025

Phone 706-575-2095

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