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Individual

PETER D. MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
611 E DOUGLAS RD STE 200, MISHAWAKA, IN 46545-1465
(574) 335-6850
(574) 335-0849
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059
(574) 335-8707

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01068029A
IN
2085R0202X
Diagnostic Radiology Physician
036164494
IL
2085R0202X
Diagnostic Radiology Physician
2023032999
MO
2085R0204X
Vascular & Interventional Radiology Physician
Primary
01068029A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201107820
IN
Enumeration date
08/01/2008
Last updated
02/12/2024
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