Individual
MARK R MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3045 E ST LUKES ST, SUITE 100, MERIDIAN, ID 83642-3507
(208) 288-2020
(208) 288-2021
Mailing address
3045 E ST LUKES ST, SUITE 100, MERIDIAN, ID 83642-3507
(208) 288-2020
(208) 288-2015
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M7853
ID
Other
Enumeration date
07/12/2006
Last updated
12/12/2015
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