Organization
MILLER FOOT & ANKLE HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S. MILLER DPM (OWNER)
(770) 386-1234
Entity
Organization
Contact information
Practice address
650 HENDERSON DRIVE, SUITE 505, CARTERSVILLE, GA 30120-3723
(770) 386-1234
(770) 386-1250
Mailing address
3450 ACWORTH DUE WEST RD, SUITE 320, KENNESAW, GA 30144-1002
(770) 386-1234
(678) 574-5549
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
POD000776
GA
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
POD000776
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
000776
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
POD000776
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1756393
MEDICAID
LA
05
—
362436212A
—
GA
Enumeration date
05/11/2006
Last updated
12/18/2013
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