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Individual

MICHELLE D MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1400 N RITTER AVE STE 375, INDIANAPOLIS, IN 46219-3049
(317) 355-9370
(317) 621-5678
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01062652A
IN
207RP1001X
Pulmonary Disease Physician
Primary
01062652A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200894810
IN
01
P01197282
RR MEDICARE PTAN
IN
01
P01212110
RR MEDICARE PTAN
IN
Enumeration date
09/26/2006
Last updated
08/19/2024
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