Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | ME34131 | FL |
NPI | 1386600617 |
---|---|
Provider Name | Dr. Joshua Miller |
First Address | Chicago, IL 60611-1005 |
Second Address | Chicago, IL 60611-1005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D66020 | (02) | FL |