Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 71878 | MA |
NPI | 1093780843 |
---|---|
Provider Name | Laurel A Miller |
First Address | Hyannis, MA 02601 |
Second Address | Hyannis, MA 02601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AA40649 | HPHC (01) | MA |
E30220 | (02) | |
J09088 | BCBS (01) | MA |