Individual
MR. JONATHAN PEASE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CCA-A
Contact information
Practice address
1915 K M WICKER MEMORIAL DR, SANFORD, NC 27330-5070
(919) 774-6829
(919) 775-2327
Mailing address
1915 K M WICKER MEMORIAL DR, SANFORD, NC 27330-5070
(919) 774-6829
(919) 775-2327
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
5019
NC
237700000X
Hearing Instrument Specialist
1032
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0107W
BCBS
NC
01
—
3404108
MEDICAID FOR HEARING AID VENDORS
NC
05
—
890107W
—
NC
Enumeration date
08/19/2008
Last updated
09/15/2009
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