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Individual

DAVID P MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
850 N HILLSIDE ST, WICHITA, KS 67214-4914
(316) 962-3070
(316) 962-3265
Mailing address
PO BOX 47490, WICHITA, KS 67201-7490
(316) 962-3150
(316) 962-7334

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-17713
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100112750B
KS
01
101479
BLUE CROSS BLUE SHIELD
KS
01
461100
CHILDRENS MERCY FAMILY HE
KS
01
621841
FIRSTGUARD
KS
Enumeration date
04/19/2006
Last updated
07/08/2007
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