Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | 02001905A | IN |
Y | 208200000X | Surgeon | 02001905A | IN |
Y | 208600000X | Surgeon | 02001905A | IN |
NPI | 1730122268 |
---|---|
Provider Name | Dr. Michael Seth Miller |
First Address | Indianapolis, IN 46234-2722 |
Second Address | Indianapolis, IN 46234-2722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 23/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200044490A | (05) | IN |
E29898 | (02) | IN |