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Individual

JEFFREY S MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5665 PEACHTREE DUNWOODY RD NE, SUITE 200, ATLANTA, GA 30342-1764
(404) 252-6104
(404) 847-9683
Mailing address
1838 AMERICAN WAY, LAWRENCEVILLE, GA 30043-6611
(770) 995-7622
(770) 995-7854

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
049145
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000892229C
GA
05
000892229F
GA
05
000892229H
GA
05
00892229A
GA
01
330005335
RRMEDICARE
GA
01
820294
BCBS EDI#
GA
Enumeration date
04/21/2006
Last updated
04/17/2013
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