Individual
SAMUEL R MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
50 BERKSHIRE CT, WYOMISSING, PA 19610-1219
(610) 373-4154
(610) 393-8651
Mailing address
50 BERKSHIRE CT, WYOMISSING, PA 19610-1219
(610) 373-4154
(610) 393-8651
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC001478L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000505185001
—
PA
01
—
045379001
DME
PA
01
—
SC001478L
MEDICAL LICENSE
PA
Enumeration date
10/14/2005
Last updated
02/02/2010
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