Individual
RICHARD A MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
240 ROOSEVELT ST, IRONWOOD, MI 49938-1737
(906) 932-3005
(906) 932-3188
Mailing address
240 ROOSEVELT ST, IRONWOOD, MI 49938-1737
(906) 932-3005
(906) 932-3188
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5330000179
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38563800
—
WI
05
—
4104809
—
MI
01
—
900B765010
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/24/2006
Last updated
06/18/2008
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