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Individual

DR. MICHAEL S. MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1610 MULKEY RD, AUSTELL, GA 30106-1182
(770) 941-3633
(770) 874-8950
Mailing address
PO BOX 108, DALLAS, GA 30132-0003
(678) 426-2171
(615) 269-3087

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD000776
GA
213EP1101X
Primary Podiatric Medicine Podiatrist
POD000776
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1756393
LA
05
362436212A
GA
Enumeration date
10/24/2005
Last updated
04/07/2023
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