Individual
MARK P MILLER
Active
Individual
MARK P MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
G28208
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G282080
—
CA
01
—
ZZZ098672
BLUE SHIELD OF CALIF
CA
Enumeration date
04/04/2006
Last updated
07/09/2009
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