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Individual

PAULINE MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
ISU THOMAS B. THIELEN STUDENT HEALTH CENTER, UNION & SHELDON DR, AMES, IA 50011-2260
(515) 294-5801
(515) 294-5742
Mailing address
ISU THOMAS B. THIELEN STUDENT HEALTH CENTER, UNION & SHELDON DR, AMES, IA 50011-2260
(515) 294-5801
(515) 294-5742

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20760
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0137653
IA
01
13765
BCBS
IA
Enumeration date
12/18/2006
Last updated
07/08/2007
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