Individual
MRS. LISA ANN MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1329 WEST 96TH STREET, SUITE 1, INDIANAPOLIS, IN 46260
(317) 660-0888
(317) 660-0880
Mailing address
1329 WEST 96TH STREE, SUITE 1, INDIANAPOLIS, IN 46260
(317) 660-0888
(317) 660-0880
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01036098A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000313363
ANTHEM
IN
05
—
100121680
—
IN
Enumeration date
07/28/2006
Last updated
03/28/2012
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