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Individual

DR. BAYARD DODGE MILLER SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1401 CENTERVILLE RD, SUITE 504, TALLAHASSEE, FL 32308-4647
(850) 431-5037
(850) 431-6101
Mailing address
1401 CENTERVILLE RD, SUITE 504, TALLAHASSEE, FL 32308-4647
(850) 431-5037
(850) 431-6101

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
2013-01015
NC
2084N0400X
Neurology Physician
Primary
ME24871
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
059244700
FL
01
17377
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/09/2006
Last updated
03/10/2016
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