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Individual

RUSSELL MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
50505 SCHOENHERR RD, STE. 340, SHELBY TOWNSHIP, MI 48315-3140
(586) 731-8400
Mailing address
50505 SCHOENHERR RD, STE. 340, SHELBY TOWNSHIP, MI 48315-3140
(586) 731-8400

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
4704281165
MI

Other

Enumeration date
02/11/2017
Last updated
02/11/2017
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