Individual
CHARLES MICHAEL MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3329 N RICHMOND ST, APPLETON, WI 54911-1063
(920) 380-2715
Mailing address
3329 N RICHMOND ST, APPLETON, WI 54911-1063
(920) 380-2715
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
64435-21
WI
Other
Enumeration date
06/19/2012
Last updated
08/06/2015
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