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Individual

DR. CHRISTOPHER TATE MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1212 PLEASANT ST, SUITE 202, DES MOINES, IA 50309-1414
(515) 244-3937
(515) 243-1442
Mailing address
1212 PLEASANT ST, SUITE 202, DES MOINES, IA 50309-1414
(515) 244-3937
(515) 243-1442

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02282
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04179
GROUP ID WELLMARK
IA
05
0496182
IA
05
0496752
IA
01
15320
WELLMARK PROVIDER NUMBER
IA
Enumeration date
05/04/2006
Last updated
07/09/2007
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