Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 35-047519 | OH |
N | 207RP1001X | Pulmonary Disease | 35-047519 | OH |
NPI | 1083617724 |
---|---|
Provider Name | Jeffrey B Miller |
First Address | Canton, OH 44708-4696 |
Second Address | Canton, OH 44708-4696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2005 |
Last Update Date | 05/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000134423 | ANTHEM BC/BS (01) | OH |
000000182183 | UNISON HEALTH PLAN (01) | OH |
0486675 | (05) | OH |
341574729029 | CARESOURCE (01) | OH |
341574729C | AULTCARE (01) | OH |
733558 | BUCKEYE COMMUNITY HEALTH (01) | OH |
A15104 | (02) | OH |
Q015961D | THE HEALTH PLAN (01) | OH |