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Individual

JUSTIN R MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
600 HEALTH PARK BLVD, SUITE D, GRAND BLANC, MI 48439-2558
(810) 603-8400
Mailing address
3495 S CENTER RD, BURTON, MI 48519-1455
(810) 424-2007
(810) 743-1099

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
5101014510
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4871363
MI
01
P00317317
RR MEDICARE
MI
Enumeration date
05/18/2006
Last updated
01/04/2010
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