Individual
THOMAS LEE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 W MAUMEE ST, ANGOLA, IN 46703-8605
(260) 665-8494
(260) 668-5690
Mailing address
1500 W MAUMEE ST, ANGOLA, IN 46703-8605
(260) 665-8494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01033506A
IN
261QR1300X
Rural Health Clinic/Center
200185720A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100225670
—
IN
05
—
200185720A
—
IN
Enumeration date
07/27/2005
Last updated
03/10/2015
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