Individual
KENNETH R MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
640 S STATE ST, DOVER, DE 19901-3530
(302) 744-6166
(302) 735-3845
Mailing address
640 S. STATE STREET, MAIL CODE 3055, DOVER, DE 19901-3530
(302) 480-1688
(302) 480-9807
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C5-0011539
DE
Other
Enumeration date
08/23/2016
Last updated
10/06/2021
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