Individual
CHEALON D MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3211 IRIS DR, COVINGTON, GA 30016-0907
(770) 787-4042
(770) 922-7499
Mailing address
3211 IRIS DR, COVINGTON, GA 30016-0907
(770) 787-4042
(770) 922-7499
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
067830
GA
390200000X
Student in an Organized Health Care Education/Training Program
0116018759
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003126579A
—
GA
Enumeration date
05/14/2007
Last updated
10/10/2012
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