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Individual

DR. SUSAN K MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
2049 E 100TH ST, DESK A10, CLEVELAND, OH 44195-2203
(216) 444-6987
Mailing address
9500 EUCLID AVE, DESK A10, CLEVELAND, OH 44195-3420
(216) 444-6987

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35059540
OH
2085U0001X
Diagnostic Ultrasound Physician
35059540
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000028415
GROUP ANTHEM ID #
OH
01
000000028694
INDIVIDUAL ANTHEM ID #
OH
05
0798445
OH
05
0909799
OH
01
300037098
INDIVIDUAL RR MEDICARE #
OH
01
341653429
GROUP TAX ID#
OH
01
34165342900
GROUP WORKERS COMP#
OH
01
341653429006
GRP MEDICAL MUTUAL OF OH.
OH
01
CC0299
GROUP RR MEDICARE #
OH
Enumeration date
07/18/2006
Last updated
08/18/2015
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