Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 022005 | CT |
N | 111NI0900X | Internist | 022005 | CT |
Y | 207RR0500X | Rheumatology | 022005 | CT |
NPI | 1083693873 |
---|---|
Provider Name | Dr. Kenneth A Miller |
First Address | Danbury, CT 06810-5954 |
Second Address | Danbury, CT 06810-5954 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 02/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001220052 | (05) | CT |
B39182 | (02) | CT |