Organization
KENNETH MILLER MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA L LALLIER CHONC (CREDENTIALING/CODING MANAGER)
(321) 362-5128
Entity
Organization
Contact information
Practice address
2500 W ROGERS AVE, BALTIMORE, MD 21215-4131
(443) 240-1682
(855) 588-5951
Mailing address
2500 W ROGERS AVE, BALTIMORE, MD 21215-4131
(443) 240-1682
(855) 588-5951
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220065100
—
MD
05
—
445791900
—
MD
Enumeration date
08/30/2010
Last updated
09/15/2022
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