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Individual

MR. DEREK STEVEN MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MMS, PA-C

Contact information

Practice address
300 S JACKSON ST, SUITE 100, DENVER, CO 80209-3176
(303) 321-0222
(303) 321-6683
Mailing address
300 S JACKSON ST, SUITE 100, DENVER, CO 80209-3176
(303) 321-0222
(303) 321-6683

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0004448
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004448
PHYSICIAN ASSISTANT COLORADO LICENSE
CO
Enumeration date
11/11/2015
Last updated
11/11/2015
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