Individual
BLAINE R MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-4660
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-0008
(602) 933-3124
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
32835
MN
207LP3000X
Pediatric Anesthesiology Physician
Primary
009491
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212681
—
AZ
05
—
291797100
—
MN
Enumeration date
05/26/2006
Last updated
01/16/2024
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