Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD009759E | PA |
NPI | 1538117486 |
---|---|
Provider Name | David Lee Miller |
First Address | Pittsburgh, PA 15241-1041 |
Second Address | Pittsburgh, PA 15241-1041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D71210 | (02) | PA |