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Individual
NELSON MILLER
Active
Individual
NELSON MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
131823
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000416190002
BLUE SHIELD
NY
05
—
00486571
—
NY
01
—
040426007600
FIDELIS
NY
01
—
10001377
CDPHP
NY
01
—
15155
MVP
NY
01
—
160012995
RAILROAD MEDICARE
NY
01
—
39D201
BLUE CROSS
NY
Enumeration date
06/10/2005
Last updated
12/15/2011
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