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Individual

MICHAEL JOSEPH MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
910 FREDERICK RD, CATONSVILLE, MD 21228-4516
(410) 644-1880
(410) 646-3623
Mailing address
910 FREDERICK RD, CATONSVILLE, MD 21228-4516
(410) 644-1880
(410) 646-3623

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C05508
MD
363AM0700X
Medical Physician Assistant
C0005508
MD
363AS0400X
Surgical Physician Assistant
C0005508
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C0005508
PA-C LICENSE
MD
Enumeration date
09/08/2014
Last updated
04/29/2022
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