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Individual

DR. RONALD A MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1111 BAKER AVE, GLACIER MEDICAL ASSOCIATES, WHITEFISH, MT 59937-2901
(406) 862-2515
(406) 862-4229
Mailing address
1111 BAKER AVE, GLACIER MEDICAL ASSOCIATES, WHITEFISH, MT 59937-2901
(406) 862-2515
(406) 862-4229

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3618
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000007830
BLUE CROSS/SHIELD PIN
MT
01
000008287
MEDICARE PART B GRP ID#
MT
05
0015301
MT
01
080026843
RAILRAID MEDICARE PIN#
MT
01
1104882232
GLACIER MEDICAL ASSOC NPI
MT
01
27D0411341
CLIA ID#--LAB CERT
MT
01
3618
MONTANA STATE LICENSE
MT
01
810350909
FEIN
MT
01
CI2709
RAILRAOD MEDICARE GRP#
MT
Enumeration date
05/05/2006
Last updated
08/11/2009
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