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Individual

DUANE MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7455 N 95TH AVE APT 1022, GLENDALE, AZ 85305-1352
(574) 364-5875
Mailing address
7455 N 95TH AVE APT 1022, GLENDALE, AZ 85305-1352
(574) 364-5875

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
01027831
IN
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
54412
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000082220
ANTHEM
IN
01
010029956
RAIL ROAD MEDICARE
IN
05
100145690
IN
05
102669220
MI
Enumeration date
03/06/2006
Last updated
02/15/2020
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