Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 34900 | MN |
N | 208600000X | Surgeon | 34900 | MN |
Y | 2086S0129X | Vascular Surgeon | 34900 | MN |
N | 2086S0129X | Vascular Surgeon | MD-44408 | IA |
NPI | 1164466074 |
---|---|
Provider Name | Dr. Brian V Miller |
First Address | Minneapolis, MN 55407-1321 |
Second Address | Saint Paul, MN 55102-2568 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020024631 | RAILROAD MEDICARE (01) | MN |
1700304 | MEDICA (01) | MN |
31783000 | (05) | WI |
984762600 | (05) | MN |
B18065 | (02) | MN |