Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 01062278A | IN |
NPI | 1083884696 |
---|---|
Provider Name | James Christopher Miller |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-2207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2008 |
Last Update Date | 16/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000638993 | ANTHEM BLUE CROSS AND BLUE SHIELD (01) | IN |
200901870 | (05) | IN |