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Individual

CLAYTON MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
520 S EAGLE RD STE 1241, MERIDIAN, ID 83642-6355
(208) 381-6930
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
5101021200
MI
208600000X
Surgery Physician
Primary
O-1628
ID
208600000X
Surgery Physician
OP60938412
WA

Other

Enumeration date
06/19/2014
Last updated
03/15/2022
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