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Individual

DR. JAMES R MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1753 FULTON ST, ELKHART, IN 46514-1927
(574) 389-9881
(574) 389-9884
Mailing address
PO BOX 1887, ELKHART, IN 46515-1887
(574) 389-5042
(574) 522-8505

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
01018808A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000109323
ANTHEM BCBS #
IN
01
000000545669
ANTHEM BCBS
IN
01
000000551983
ANTHEM, BCBS FMC
IN
05
100111270
IN
05
100111270A
IN
Enumeration date
07/18/2005
Last updated
06/20/2011
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