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Individual

JORDAN MILLER CASE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
WAKE FOREST BAPTIST HEALTH MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-8668
(336) 716-8200
(336) 716-8018
Mailing address
DEPARTMENT OF ORTHOPAEDIC SURGERY MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-1070
(336) 716-8200
(336) 716-8018

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2018-00089
NC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
2018-00089
NC

Other

Enumeration date
06/09/2009
Last updated
03/19/2019
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