Individual
IVAN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CLARA MAASS DR, CLARA MAASS MEDICAL CENTER (EMERGENCY DEPARTMENT), BELLEVILLE, NJ 07109-3550
(973) 450-2100
Mailing address
PO BOX 717, LIVINGSTON, NJ 07039-0717
(973) 740-0607
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
217211
NY
207P00000X
Emergency Medicine Physician
25MA07413300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8852901
—
NJ
Enumeration date
06/02/2006
Last updated
01/15/2025
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