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Individual

MICHAEL GLENN MILLER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
515 28TH ST, #101, DES MOINES, IA 50312-5259
(515) 282-6067
Mailing address
515 28TH ST, #101, DES MOINES, IA 50312-5259
(515) 282-6067

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
316
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0070078
IA
Enumeration date
01/18/2006
Last updated
07/08/2007
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