Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 3948028 | TN |
N | 207R00000X | Internist | MD0000009589 | TN |
N | 111NI0900X | Internist | MD0000009589 | TN |
Y | 207RA0401X | Internist - Addiction Medicine | MD0000009589 | TN |
NPI | 1619958949 |
---|---|
Provider Name | Dr. Michael P Miller |
First Address | Nashville, TN 37203-2203 |
Second Address | Nashville, TN 37203-2203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 18/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3180220 | (05) | TN |
B03894 | (02) | TN |