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Individual

CHRISTOPHER D MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1542 MEDICAL PARK CIR, TUPELO, MS 38801-6560
(662) 844-4711
(662) 844-9619
Mailing address
1542 MEDICAL PARK CIR, TUPELO, MS 38801-6560
(662) 844-4711
(662) 844-9619

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
18767
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009940454
AL
05
03524309
MS
01
1339855
BLUE CROSS BLUE SHIELD
01
18767
STATE ID NUMBER
Enumeration date
01/24/2006
Last updated
06/30/2008
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