Individual
GWEN GIANNINI MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
16400 HILLIARD RD, LAKEWOOD, OH 44107-5610
(216) 228-1800
(440) 333-0273
Mailing address
21375 LORAIN RD, FAIRVIEW PARK, OH 44126-2122
(440) 333-7346
(440) 333-0273
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5258/T2164
OH
152W00000X
Optometrist
OE008485T
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275512709
PRACTICE NPI
OH
05
—
2860999
—
OH
01
—
P00721313
RAILROAD MEDICARE
OH
Enumeration date
07/17/2006
Last updated
07/30/2009
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