Individual
DR. LAWRENCE GORDON MILLER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8002 DISCOVERY DR, SUITE 101, RICHMOND, VA 23229-8601
(804) 282-2848
(804) 673-3546
Mailing address
8002 DISCOVERY DR, SUITE 101, RICHMOND, VA 23229-8601
(804) 282-2848
(804) 673-3546
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
0101032522
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
0101032522
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006205917
—
VA
01
—
045806
ANTHEM BLUECROSS BLUESHIE
VA
01
—
24848
MDIPA
VA
01
—
501270
AETNA
VA
01
—
541421810
TAX ID
VA
Enumeration date
07/24/2006
Last updated
10/17/2017
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