Individual
TIMOTHY ISAAC MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4840 23RD AVE S, FARGO, ND 58104-9136
(701) 417-6999
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9419
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MDRE.ML.60952186
WA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
22190
ND
Other
Enumeration date
03/29/2019
Last updated
08/06/2025
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