Individual
EVAN T MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4725 STATESMEN DR, STE. C-D, INDIANAPOLIS, IN 46250-5644
(317) 577-4200
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01069212A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11014750A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201067880
—
IN
01
—
Q00166434
RAILROAD PTAN
IN
Enumeration date
05/16/2009
Last updated
12/05/2024
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