Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 25MA2361500 | NJ |
N | 207U00000X | Nuclear Medicine Specialist | 25MA2361500 | NJ |
NPI | 1770565251 |
---|---|
Provider Name | Charles Luther Miller |
First Address | Red Bank, NJ 07701-8519 |
Second Address | Shrewsbury, NJ 07702-4332 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 12/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110089519 | MEDICARE RAILROAD (01) | |
2423405 | (05) | NJ |
273678 | UNITED HEALTHCARE (01) | NJ |
539441 | EMPIRE BCBS OF NY (01) | |
539442 | EMPIRE BCBS OF NY (01) | |
549791 | AETNA (01) | |
D96995 | (02) | |
MP178 | OXFORD HEALTH PLANS (01) | NJ |
OK4747 | HEALTH NET OF NEW JERSEY (01) |