Individual
THERESA L MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 N MEDICAL PARK DR, FISHERSVILLE, VA 22939-2344
(540) 213-2630
(540) 213-2631
Mailing address
PO BOX 388, FISHERSVILLE, VA 22939-0388
(540) 932-4629
(540) 932-5875
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101051765
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005853575
—
VA
01
—
142720
SOUTHERN HEALTH
VA
01
—
2182360
FIRST HEALTH
VA
01
—
285567
ANTHEM
VA
01
—
41819
OPTIMA
VA
01
—
5853575
VA PREMIER
VA
01
—
700011406
CIGNA
VA
Enumeration date
02/08/2006
Last updated
01/03/2013
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