Organization
GARY MILLER MD LLC
Active
Organization
GARY MILLER MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY MILLER MD (OWNER)
(860) 314-6898
Entity
Organization
Contact information
Practice address
61 BRADLEY ST, BRISTOL, CT 06010
(860) 314-6898
(860) 314-6896
Mailing address
61 BRADLEY ST, BRISTOL, CT 06010
(860) 314-6898
(860) 314-6896
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004220985
—
CT
01
—
07D0092369
CLIA
—
Enumeration date
03/09/2006
Last updated
11/24/2009
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