Individual
DR. GLENN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2410 S BROAD ST, 3RD FLR, PHILADELPHIA, PA 19145-4418
(215) 462-6600
(215) 462-2650
Mailing address
3831 RAMAGE RUN, HUNTINGDON VALLEY, PA 19006-2453
(215) 938-0254
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD033553E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0111120000
AMERIHEALTH PC & HMO
NJ
05
—
011223020
—
PA
01
—
0112230205
ALL IBC PRODUCTS
PA
01
—
050088759
RR MEDICARE
PA
01
—
20033920
AMERIHEALTH MERCY
NJ
01
—
2992866
AETNA
PA
01
—
30003770
HORIZON NJ HEALTH
NJ
01
—
30003770
KEYSTONE MERCY
PA
01
—
3039
BRAVO BY ELDER HEALTH
PA
01
—
517607
AMERIHEALTH ADMINISTRATOR
NJ
01
—
517607
ALL BLUE SHIELD
PA
Enumeration date
11/20/2006
Last updated
07/08/2007
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