Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 208211 | MA |
NPI | 1003855099 |
---|---|
Provider Name | Katherine E Miller |
First Address | Cambridge, MA 02139-3647 |
Second Address | Cambridge, MA 02139-3647 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 24/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0116611 | (05) | MA |
3449997 | AETNA (01) | MA |
4561720 | CIGNA (01) | MA |
MIJ23235 | BCBS (01) | MA |