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Individual
SUSAN M MILLER
Active
Individual
SUSAN M MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA001001L
PA
363AM0700X
Medical Physician Assistant
MA001001L
PA
363AS0400X
Surgical Physician Assistant
MA001001L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50057839
CAPITAL BC
PA
Enumeration date
07/05/2006
Last updated
10/29/2021
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