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Individual

RONALD MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
220 RICHMOND AVE E, MATTOON, IL 61938-4652
(217) 234-3937
(217) 234-3930
Mailing address
220 RICHMOND AVE E, MATTOON, IL 61938-4652
(217) 234-3937
(217) 234-3930

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036060611
IL

Other

Enumeration date
10/21/2005
Last updated
02/13/2012
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