Individual
DAVID L MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
505 E GRANT ST, STE 103, MACOMB, IL 61455-3352
(309) 833-3536
(309) 836-5729
Mailing address
PO BOX 556, MACOMB, IL 61455-0556
(309) 833-2868
(309) 836-3779
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036104354
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036104354
—
IL
01
—
067033
HEALTH ALLIANCE
IL
01
—
110247080
RAILROAD MEDICARE
IL
01
—
5532005
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
06/17/2005
Last updated
11/10/2011
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