Individual
WARREN N. MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4400 E FLAMINGO AVE, NAMPA, ID 83687-9203
(208) 288-4970
(208) 463-3044
Mailing address
217 W GEORGIA AVE, STE 115, NAMPA, ID 83686-6811
(208) 463-3234
(208) 463-3044
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M3815
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010005751
BLUE SHIELD
ID
01
—
000010138751
BLUE SHIELD
ID
05
—
002365600
—
ID
01
—
070004831
RAILROAD MEDICARE
ID
01
—
28634
BLUE CROSS
ID
01
—
38158
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
12/26/2013
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