Individual
DR. NICHOLAS JAY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 660-1616
Mailing address
36123 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(913) 660-1616
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2016007201
MO
208M00000X
Hospitalist Physician
Primary
05-40104
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992123061
—
MO
05
—
201169390A
—
KS
Enumeration date
04/04/2014
Last updated
02/07/2024
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