Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 22157 | AZ |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 22157 | AZ |
NPI | 1336132653 |
---|---|
Provider Name | Curtis D Miller |
First Address | Phoenix, AZ 85038-9870 |
Second Address | Avondale, AZ 85392-4802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 24/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
345935 | (05) | AZ |
3Z3989 | HEALTHNET (01) | AZ |