# KENNETH MILLER MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114233012
- **Authorized official:** MRS. TARA L LALLIER CHONC (CREDENTIALING/CODING MANAGER)
- **Authorized official phone:** (321) 362-5128

## Contact information

- **Practice address:** 2500 W ROGERS AVE, BALTIMORE, MD 21215-4131
- **Practice address phone:** (443) 240-1682
- **Practice address fax:** (855) 588-5951
- **Mailing address:** 2500 W ROGERS AVE, BALTIMORE, MD 21215-4131
- **Mailing address phone:** (443) 240-1682
- **Mailing address fax:** (855) 588-5951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | Yes |
| 207RH0003X | Hematology & Oncology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2010
- **Last updated:** 09/15/2022