Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 35-047095 | OH |
NPI | 1073533162 |
---|---|
Provider Name | Martha J Miller |
First Address | Mayfield Hts, OH 44124-6508 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 14/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000028240 | ANTHEM (01) | OH |
000000221300 | UNISON (01) | OH |
000000526107 | ANTHEM (01) | OH |
0545502 | (05) | OH |
A15991 | (02) | OH |