Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 35-055796 | OH |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 35.055796 | OH |
NPI | 1326019100 |
---|---|
Provider Name | Debra Ann Miller |
First Address | Centerville, OH 45459-4465 |
Second Address | Centerville, OH 45459-4465 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 25/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0686931 | (05) | OH |
E89401 | (02) | OH |