Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 03206 | AZ |
NPI | 1467721456 |
---|---|
Provider Name | David Steven Miller |
First Address | Phoenix, AZ 85029-5212 |
Second Address | Glendale, AZ 85308-8240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2011 |
Last Update Date | 20/12/2011 |