Individual
MELISSA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
516 NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
(505) 722-1310
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1310
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
1766
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5700497000
—
WV
Enumeration date
06/27/2006
Last updated
02/03/2011
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