Individual
GREGORY A MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
975 YOUNG ST, NAUVOO, IL 62354
(217) 440-3837
Mailing address
PO BOX 215, 975 YOUNG ST, NAUVOO, IL 62354
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01030135
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200319870A
—
IN
Enumeration date
08/10/2005
Last updated
09/27/2012
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