Individual
MERIDA A MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4155 CTY RD 101 N, PLYMOUTH, MN 55446
(952) 993-8900
(952) 993-8955
Mailing address
8170 33RD AVE S, PO BOX 1309 MAIL STOP 21110Q, MINNEAPOLIS, MN 55425-4516
(952) 993-8900
(952) 993-8955
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
37302
IA
207V00000X
Obstetrics & Gynecology Physician
Primary
58634
MN
207V00000X
Obstetrics & Gynecology Physician
R-7121
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56646
WELLMARK BCBS
IA
Enumeration date
05/23/2007
Last updated
03/16/2016
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