Individual
DR. EDWARD B MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
914 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-5990
Mailing address
635 LASSEN LN, MOUNT SHASTA, CA 96067-9003
(530) 926-5990
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G27556
CA
207X00000X
Orthopaedic Surgery Physician
MD10363
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006313
—
OR
01
—
00G275560
BLUE SHIELD
CA
05
—
00G275560
—
CA
Enumeration date
04/03/2006
Last updated
10/21/2011
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