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Individual

DR. MITCHELL B MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2109 MCCOMAS WAY, STE 102, VIRGINIA BEACH, VA 23456-3909
(757) 563-2800
(757) 563-2300
Mailing address
2109 MCCOMAS WAY, STE 102, VIRGINIA BEACH, VA 23456-3909
(757) 563-2800
(757) 563-2300

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101032190
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005643350
VA
01
080150542
RAILROAD MEDICARE
VA
01
208896
ANTHEM
VA
01
37450
OPTIMA
VA
Enumeration date
05/30/2005
Last updated
11/30/2007
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