Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD462776 | PA |
Y | 208600000X | Surgeon | MD462776 | PA |
NPI | 1013216530 |
---|---|
Provider Name | Dr. Corrine Blumling Miller |
First Address | Danville, PA 17822-4903 |
Second Address | Wilkes Barre, PA 18711-0027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2011 |
Last Update Date | 24/01/2019 |