Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 41376 | MA |
N | 207V00000X | Obstetrician & Gynecologist | 41376 | MA |
NPI | 1609933399 |
---|---|
Provider Name | Dr. Wayne Alexander Miller |
First Address | West Barnstable, MA 02668-0711 |
Second Address | West Barnstable, MA 02668-1404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B98708 | (02) | MA |