Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 3392 | OH |
NPI | 1093701476 |
---|---|
Provider Name | Dr. Andrew Wade Miller |
First Address | Dover, OH 44622-3004 |
Second Address | Dover, OH 44622-3004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 12/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2642537 | (05) | OH |
9378401 | MEDICARE GROUP NUMBER (01) | OH |
P00662344 | RAILROAD (01) | OH |