Individual
DR. KENNETH ANDREW MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
(920) 568-6090
(920) 568-6083
Mailing address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
(920) 568-6090
(920) 568-6083
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29654
WI
208M00000X
Hospitalist Physician
11253504-1205
UT
208M00000X
Hospitalist Physician
M-13495
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962543496
—
WI
Enumeration date
02/09/2007
Last updated
03/30/2020
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