Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N003771-1 | NY |
NPI | 1003820655 |
---|---|
Provider Name | Dr. William M Miller |
First Address | Port Chester, NY 10573-5162 |
Second Address | Port Chester, NY 10573-5162 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 22/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1708601 | (05) | NJ |
T45357 | (02) |