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Individual

DR. MICHAEL MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
676 WYOMING AVE, SUITE 104, KINGSTON, PA 18704-3857
(570) 287-1400
Mailing address
480 PIERCE ST, STE 205, KINGSTON, PA 18704-5512
(570) 287-1400

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
OS008632L
PA
208D00000X
General Practice Physician
Primary
05008632L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001729923
PA
Enumeration date
04/07/2006
Last updated
04/30/2019
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