Individual
THOMAS PAUL MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3625 CLYDE PARK AVE SW, SUITE 1, GRAND RAPIDS, MI 49509-4023
(616) 531-6900
(616) 531-5847
Mailing address
3625 CLYDE PARK AVE SW, SUITE 1, GRAND RAPIDS, MI 49509-4023
(616) 531-6900
(616) 531-5847
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
4301051779
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2860745
—
MI
Enumeration date
07/20/2006
Last updated
07/08/2007
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