Active NPI
Michael Edward Liles
- Radiologic Technologist
- Millville, NJ
National Provider Identifier
1073962577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- 634660
- Practice address
- 528 Hogbin Rd
Millville, NJ 08332-5228 - Phone
- (856) 265-8772
- Fax
- (856) 506-8647
- NPI assigned
- Jun 7, 2016
- Last updated
- Jun 7, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | 634660 | NJ | Primary |
Addresses
Primary practice location
528 Hogbin Rd
Millville, NJ 08332-5228
Mailing address
528 Hogbin Rd
Millville, NJ 08332-5228
Phone (856) 265-8772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 634660 | NJ | MD | Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465257600000",
"number": "1073962577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "528 HOGBIN RD",
"city": "MILLVILLE",
"state": "NJ",
"postal_code": "083325228",
"telephone_number": "856-265-8772",
"fax_number": "856-506-8647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "528 HOGBIN RD",
"city": "MILLVILLE",
"state": "NJ",
"postal_code": "083325228",
"telephone_number": "856-265-8772",
"fax_number": "856-506-8647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILES",
"first_name": "MICHAEL",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-07",
"last_updated": "2016-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "NJ",
"license": "634660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Millville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.