Individual
ETHAN D MILLER
Active
Individual
ETHAN D MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
N7463
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219436701
—
TX
01
—
8CN793
BCBS
TX
01
—
P00917313
RR MEDICARE
TX
Enumeration date
05/07/2007
Last updated
06/13/2012
Update your record
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