Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 66705 | MN |
N | 207RR0500X | Rheumatology | 72681-20 | WI |
NPI | 1134514201 |
---|---|
Provider Name | Eric S Miller |
First Address | Bloomington, MN 55425-4516 |
Second Address | Saint Paul, MN 55130-5302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2015 |
Last Update Date | 08/07/2020 |