Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 4092 | SD |
NPI | 1285613331 |
---|---|
Provider Name | Lee Patrick Miller |
First Address | Sioux Falls, SD 57105-6706 |
Second Address | Sioux Falls, SD 57105-6706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2006 |
Last Update Date | 20/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0919563 | (05) | IA |
10025286300 | (05) | NE |
124216400 | (05) | MN |
240005059 | RAILROAD MEDICARE (01) | |
7301460 | (05) | SD |
E84597 | (02) | SD |