Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | MD461130 | PA |
NPI | 1376802884 |
---|---|
Provider Name | Brett Miller |
First Address | Doylestown, PA 18901-2622 |
Second Address | Doylestown, PA 18901-2622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2012 |
Last Update Date | 24/07/2019 |