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Individual

DR. STEPHEN J MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2855 E MAGIC VIEW DR, MERIDIAN, ID 83642-6245
(208) 639-4900
(208) 639-4901
Mailing address
2855 E MAGIC VIEW DR, MERIDIAN, ID 83642-6245
(208) 639-4900
(208) 639-4901

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
M-9365
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010151600
BLUE SHIELD BOISE
ID
01
000010151601
BLUE SHILED MERIDIAN
ID
01
75614
BLUE CROSS BOISE
ID
05
807223100
ID
01
B5601
BLUE CROSS MERIDIAN
ID
01
P00273320
RAILROAD MEDICARE
ID
Enumeration date
05/16/2006
Last updated
03/04/2009
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