Individual
DR. KENNETH D MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16 OLD BROOKSIDE ROAD, RANDOLPH, NJ 07869
(973) 895-4000
(973) 895-3310
Mailing address
PO BOX 95000 LB#7550, PHILADELPHIA, PA 19195-7550
(844) 362-1735
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA34422
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0736771010
CIGNA
NJ
05
—
0920401
—
NJ
01
—
IP099
OXFORD
NJ
Enumeration date
10/16/2006
Last updated
12/30/2021
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