# DR. LAWRENCE GORDON MILLER III

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1417979865
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173000000X | Legal Medicine | 0101032522 | VA | — |
| 207V00000X | Obstetrics & Gynecology Physician | 0101032522 | VA | Yes |

## Other

- **Enumeration date:** 07/24/2006
- **Last updated:** 10/17/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 006205917 | — | VA |
| 01 | — | 045806 | ANTHEM BLUECROSS BLUESHIE | VA |
| 01 | — | 24848 | MDIPA | VA |
| 01 | — | 501270 | AETNA | VA |
| 01 | — | 541421810 | TAX ID | VA |