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Individual

DR. MARK D. MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
400 RAY C HUNT DR, SUITE 330, CHARLOTTESVILLE, VA 22903-2980
(434) 982-4832
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
0101228023
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821065848
VA
Enumeration date
03/08/2006
Last updated
11/01/2012
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