Individual
NICHOLAS P MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
429 S LANDMARK AVE, BLOOMINGTON, IN 47403-5003
(812) 332-8242
(812) 333-7684
Mailing address
PO BOX 4366, BLOOMINGTON, IN 47402-4366
(812) 332-8242
(812) 333-7684
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01072515A
IN
2085R0202X
Diagnostic Radiology Physician
036.129482
IL
2085R0202X
Diagnostic Radiology Physician
125-054108
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01072515A
MEDICAL LICENSE
IN
01
—
01072515B
CSR
IN
01
—
1194981712
NPI
—
Enumeration date
08/03/2008
Last updated
12/12/2023
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