Individual
DR. MARVIN JAY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10765 LANTERN RD, SUITE 102, FISHERS, IN 46038-3597
(317) 621-4181
(317) 621-4182
Mailing address
10765 LANTERN RD, SUITE 102, FISHERS, IN 46038-3597
(317) 621-4181
(317) 621-4182
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01024897A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000716275
ANTHEM
IN
05
—
200104350
—
IN
05
—
200931580A
—
IN
01
—
2191038
CIGNA
IN
01
—
7177448
AETNA
IN
01
—
D03211
MEDICARE RR
IN
Enumeration date
08/15/2005
Last updated
04/03/2012
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