Individual
NATHAN G MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6440 S WASATCH BLVD, HOLLADAY, UT 84121-3511
(918) 786-7780
Mailing address
6440 S WASATCH BLVD, HOLLADAY, UT 84121-3511
(918) 786-7780
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
24920
OK
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
8858699-1205
UT
2086S0122X
Plastic and Reconstructive Surgery Physician
ME94005
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100747570F
—
OK
05
—
200265920A
—
OK
01
—
8W0850
BC/BS OF TEXAS
TX
01
—
DC3959
RR MEDICARE
OK
01
—
P01126512
RR MEDICARE
OK
Enumeration date
02/07/2006
Last updated
11/14/2024
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