Individual
BRIDGET SHAKIRA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.,
Contact information
Practice address
210 N LAFAYETTE ST, SOUTH LYON, MI 48178-2048
(248) 437-1744
Mailing address
22250 PROVIDENCE DR STE 500, SOUTHFIELD, MI 48075-6213
(248) 849-3447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301095194
MI
207Q00000X
Family Medicine Physician
5315042397
MI
Other
Enumeration date
07/02/2009
Last updated
07/02/2009
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