Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 28397 | CO |
Y | 207RH0000X | Hematologist | D0063489 | MD |
NPI | 1316482128 |
---|---|
Provider Name | Jeffery Miller |
First Address | Bethesda, MD 20892-0001 |
Second Address | Bethesda, MD 20892-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2017 |
Last Update Date | 03/01/2017 |