Individual
CHARLES P MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
321 W 4TH ST, THE DALLES, OR 97058-1807
(541) 340-5794
(844) 965-9029
Mailing address
321 W 4TH ST, THE DALLES, OR 97058-1807
(541) 340-5794
(844) 965-9029
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD22088
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134303
—
OR
05
—
218112
—
OR
Enumeration date
11/18/2005
Last updated
03/17/2016
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