Individual
WENDY A MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-4477
(860) 679-4474
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
040451
CT
208M00000X
Hospitalist Physician
040451
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1404516
—
CT
Enumeration date
06/24/2005
Last updated
09/29/2022
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