Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 57986 | TN |
Y | 2080P0203X | Pediatric Critical Care Doctor | 57986 | TN |
NPI | 1073909396 |
---|---|
Provider Name | Dr. Michael Miller |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232-9760 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2015 |
Last Update Date | 08/09/2021 |