Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 0101257533 | VA |
NPI | 1013980036 |
---|---|
Provider Name | Charles Joseph Miller |
First Address | Richmond, VA 23229-4605 |
Second Address | Richmond, VA 23229-4605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 26/02/2016 |