Individual
JONATHAN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6161 KEMPSVILLE CIR, SUITE 225, NORFOLK, VA 23502-3932
(757) 455-6368
(757) 455-6686
Mailing address
3241 WESTERN BRANCH BLVD, CHESAPEAKE, VA 23321-5260
(757) 686-3508
(757) 686-0541
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101031994
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010021456
—
VA
01
—
22885
SENTARA
VA
01
—
268371
ANTHEM
VA
01
—
541595397
PRIVATE HEALTHCARE SYSTEM
VA
Enumeration date
02/15/2006
Last updated
04/12/2010
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