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Individual

MICHAEL R MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3055 HUBERTUS RD, HUBERTUS, WI 53033
(262) 628-9000
(262) 628-7255
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31901
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31761300
WI
01
P00941490
RR MEDICARE
WI
Enumeration date
07/07/2006
Last updated
12/03/2025
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