Individual
MATTHEW K MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 GAUSE BLVD, SLIDELL, LA 70458
(985) 649-8767
Mailing address
120 INNWOOD DR, COVINGTON, LA 70433-9123
(985) 892-3225
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
021272
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1661651
—
LA
Enumeration date
05/30/2005
Last updated
07/05/2018
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