Individual
CRAIG B MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2349 LAKE AVE STE 100, PLYMOUTH, IN 46563-7836
(574) 948-5100
(574) 948-5499
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059
(574) 335-8707
(574) 335-8741
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01050910
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102406683
ANTHEM
IN
05
—
200272700A
—
IN
Enumeration date
06/29/2006
Last updated
02/19/2024
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