Individual
KENNETH L MILLER
Active
Individual
KENNETH L MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
109972
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109972
LICENSE NUMBER
—
01
—
14989V14989
GHP
—
01
—
290568
CMR
—
01
—
8707
HEALTHCARE
—
01
—
945K1
BCBS MO
MO
01
—
945K1
MO BLUE
—
01
—
G23727
NATIONAL REGISTRY NUMBER
—
01
—
STL1600408
UHC
—
Enumeration date
08/09/2006
Last updated
11/26/2007
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