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Individual

DR. MARK E MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
269 S CANDY LN, COTTONWOOD, AZ 86326-4158
(928) 639-6180
(928) 639-6698
Mailing address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 773-2559
(928) 213-6292

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
36457
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
5414499-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
264578
AZ
Enumeration date
12/19/2006
Last updated
12/18/2015
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