# MILLER FAMILY PRACTICE PC

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

## Provider details

- **NPI number:** 1225134166
- **Authorized official:** MICHAEL RAY MILLER MD (OWNER)
- **Authorized official phone:** (704) 872-0174

## Contact information

- **Practice address:** 513 BROOKDALE DRIVE, STATESVILLE, NC 28677
- **Practice address phone:** (704) 872-0174
- **Practice address fax:** (704) 872-0176
- **Mailing address:** 513 BROOKDALE DRIVE, STATESVILLE, NC 28677
- **Mailing address phone:** (704) 872-0174
- **Mailing address fax:** (704) 872-0176

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 117782 | NC | Yes |

## Other

- **Enumeration date:** 09/16/2006
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 59036 | BCBS | NC |
| 05 | — | 8959036 | — | NC |