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Individual

STANLEY D MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1690 SKYLYN DR STE 300B, SPARTANBURG, SC 29307-1022
(864) 342-4000
(864) 596-7409
Mailing address
PO BOX 743070, ATLANTA, GA 30384-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20532
SC
207RI0200X
Infectious Disease Physician
Primary
20532
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
205325
SC
01
P00423935
MEDICARE RAILROAD PTAN#
GA
01
SCE4955019
MEDICARE PIN
SC
Enumeration date
05/23/2006
Last updated
05/18/2021
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