Active NPI
Samuel Milham, MD
- Other Technician
- Olympia, WA
National Provider Identifier
1306141551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- MD 00010492
- Practice address
- 2318 Gravelly Beach Loop NW
Olympia, WA 98502-8837 - Phone
- (360) 866-0256
- NPI assigned
- Jan 19, 2011
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | MD 00010492 | WA | Primary |
Addresses
Primary practice location
2318 Gravelly Beach Loop NW
Olympia, WA 98502-8837
Mailing address
2318 Gravelly Beach Loop NW
Olympia, WA 98502-8837
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD 00010492 | Other | WA | WASHINGTON STATE MEDICAL LICENSE |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD 00010492 | WA | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295395200000",
"number": "1306141551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2318 GRAVELLY BEACH LOOP NW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985028837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2318 GRAVELLY BEACH LOOP NW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985028837",
"telephone_number": "360-866-0256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILHAM",
"first_name": "SAMUEL",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-19",
"last_updated": "2011-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "WA",
"license": "MD 00010492",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE MEDICAL LICENSE",
"identifier": "MD 00010492",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.