Individual
DR. MARK IAN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
570 SOUTH AVE E BLDG A, CRANFORD, NJ 07016-3266
(908) 603-4200
(908) 497-1633
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA06548700
NJ
208800000X
Urology Physician
Primary
25MA06548700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7277300
—
NJ
Enumeration date
10/17/2005
Last updated
03/07/2022
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