Iam Integrative & Aesthetic Medicine, LTD.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

6702-20 Issued in WI

Legal business name

IAM INTEGRATIVE & AESTHETIC MEDICINE, LTD.

Practice address

10602 N Port Washington Rd
Ste. 101
Mequon, WI 53092-5079

Phone

(415) 866-8757

NPI assigned

Oct 10, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Adam C Miller, MD

Title

President

Phone

(415) 866-8757

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412899200000",
    "number": "1568866150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10602 N PORT WASHINGTON RD",
            "address_2": "STE. 101",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10602 N PORT WASHINGTON RD",
            "address_2": "STE. 101",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925079",
            "telephone_number": "415-866-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAM INTEGRATIVE & AESTHETIC MEDICINE, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-10",
        "last_updated": "2014-10-10",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-866-8757",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "6702-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Mequon, WI
• Providers in Mequon, WI by specialty
• Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.