Individual
LAVERNE L MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 KINGSTON RD, GREENWOOD, SC 29649-9570
(260) 760-0956
Mailing address
210 KINGSTON RD, GREENWOOD, SC 29649-9570
(260) 760-0956
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
MD88243
SC
207QG0300X
Geriatric Medicine (Family Medicine) Physician
01035849
IN
207QG0300X
Geriatric Medicine (Family Medicine) Physician
35045593
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0454235
—
OH
Enumeration date
09/21/2005
Last updated
07/08/2022
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