Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | R3901 | AR |
NPI | 1376552315 |
---|---|
Provider Name | Dr. Michael M Miller |
First Address | Little Rock, AR 72205-6324 |
Second Address | Little Rock, AR 72205-6324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 05/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
114614001 | (05) | AR |
E30160 | (02) | AR |