Individual
DR. KWON T. MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
715 E WESTERN RESERVE RD, YOUNGSTOWN, OH 44514-3358
(330) 726-3204
(330) 729-9316
Mailing address
PO BOX 636988, CINCINNATI, OH 45263-6988
(888) 940-2722
(513) 632-8898
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
34009913
OH
207RC0000X
Cardiovascular Disease Physician
OS012150
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001947190
—
PA
05
—
0019616090004
—
PA
05
—
3074766
—
OH
01
—
4303762
MEDICARE PTAN
OH
Enumeration date
04/07/2006
Last updated
10/02/2015
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