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Individual

DR. LISA DAWN MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4152 BAKER ST NE, COVINGTON, GA 30014-1404
(770) 788-1077
(770) 788-0768
Mailing address
4152 BAKER ST NE, COVINGTON, GA 30014-1404
(770) 788-1077
(770) 788-0768

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
038874
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00512
BCBS
GA
05
00618945D
GA
05
00618945E
GA
Enumeration date
12/05/2006
Last updated
09/07/2011
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