Individual
DANIEL RAYMOND MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
321 SKYLINE DR, LEWISTON, ID 83501-4220
(208) 791-6718
(208) 743-0528
Mailing address
321 SKYLINE DR, LEWISTON, ID 83501-4220
(208) 791-6718
(208) 743-0528
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M-3254
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
,OO2456100
—
IA
Enumeration date
01/31/2007
Last updated
07/08/2007
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