Individual
GARY L MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
830 OAK ST, STE 205W, BROCKTON, MA 02301-1191
(508) 583-4440
(508) 583-7401
Mailing address
960 MASSACHUSETTS AVE, FL 2, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
54240
MA
207RC0000X
Cardiovascular Disease Physician
Primary
54240
MA
207UN0901X
Nuclear Cardiology Physician
54240
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110042580A
—
MA
05
—
3002543
—
MA
05
—
3154030
—
NH
Enumeration date
10/14/2006
Last updated
04/21/2026
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