Individual
MARK ALLEN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
42244
TN
207RG0100X
Gastroenterology Physician
Primary
42244
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3000495
—
TN
01
—
4159171
BLUE CROSS BLUE SHIELD
TN
01
—
5239535
AETNA
TN
01
—
P00480194
RR MEDICARE
TN
Enumeration date
07/08/2005
Last updated
01/29/2024
Update your record
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