Individual
ROBERT WILLIAM MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 SUMMIT CROSSING PL, STE 106, GASTONIA, NC 28054-2176
(704) 867-8021
(704) 864-4606
Mailing address
620 SUMMIT CROSSING PL, STE 106, GASTONIA, NC 28054-2176
(704) 867-8021
(704) 864-4606
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
200101577
NC
2085R0204X
Vascular & Interventional Radiology Physician
Primary
2001 01577
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1300K
BLUE CROSS BLUE SHIELD
—
01
—
16 00493
UNITED HEALTHCARE
—
01
—
300135815
RAILROAD MEDICARE
—
01
—
3616605
AETNA HMO
—
01
—
46448
PARTNERS
—
01
—
759459
AETNA PPO
—
05
—
891300K
—
NC
01
—
B3672
MEDCOST
—
05
—
N01577
—
SC
Enumeration date
12/08/2005
Last updated
08/23/2010
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