Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 0102201618 | VA |
N | 207V00000X | Obstetrician & Gynecologist | OS014115 | PA |
Y | 207VX0201X | Gynecologic Oncologist | OS014115 | PA |
NPI | 1265572093 |
---|---|
Provider Name | Dr. Mark Andrew Miller |
First Address | Mechanicsburg, PA 17050-9422 |
Second Address | Mechanicsburg, PA 17050-9422 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 14/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102281226 | (05) | PA |
102281266 | (05) | PA |
2092940 | HIGHMARK BLUE SHIELD (01) | PA |