Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | OS005918L | PA |
NPI | 1336253517 |
---|---|
Provider Name | Donna L Miller |
First Address | Bethlehem, PA 18016-1338 |
Second Address | Bethlehem, PA 18015-1000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 05/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E76441 | (02) | PA |