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Individual

DR. DEBRA R MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
53 GRANITE ST, NEW LONDON, CT 06320-5917
(860) 447-1419
(860) 442-2604
Mailing address
53 GRANITE ST, NEW LONDON, CT 06320-5917
(860) 447-1419
(860) 442-2604

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036169
CT
207NS0135X
Procedural Dermatology Physician
036169
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001361691
CT
Enumeration date
07/07/2005
Last updated
06/27/2008
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