Individual
BART J MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
704 S WEBSTER AVE, STE 100, GREEN BAY, WI 54301-3528
(920) 433-3456
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2310
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43021900
—
WI
Enumeration date
07/18/2008
Last updated
12/04/2014
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