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Individual

DEVON MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1111 HAYES AVE, SANDUSKY, OH 44870
(419) 557-7455
Mailing address
419 E. PERKINS AVENUE, SANDUSKY, OH 44870-4901
(419) 557-7455

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
340625
LA
363AM0700X
Medical Physician Assistant
Primary
50.009195RX
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0096761
OH
Enumeration date
01/15/2024
Last updated
02/18/2025
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