Individual
MR. KELLY MICHAEL MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
COMMANDING OFFICER MEDICAL COMPANY, CSSG-3 BOX 63067 MCBH, KANEOHE BAY, HI 96863
(808) 257-1572
Mailing address
46-271 KAHUHIPA ST APT E109, KANEOHE, HI 96744-6024
(808) 271-5490
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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