Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 27046 | WI |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 27046 | WI |
NPI | 1407888647 |
---|---|
Provider Name | Dennis P Miller |
First Address | Wauwatosa, WI 53226-4216 |
Second Address | Wauwatosa, WI 53226-4216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 21/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31500400 | (05) | WI |
E47075 | (02) |