Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 142504 | NC |
N | 207N00000X | Dermatologist | 45752 | TN |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 45752 | TN |
NPI | 1033398532 |
---|---|
Provider Name | Dr. Drew Wilson Miller |
First Address | Knoxville, TN 37920-1504 |
Second Address | Knoxville, TN 37920-1504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2007 |
Last Update Date | 05/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1519855 | (05) | TN |