Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 35-064454 | OH |
N | 208000000X | Pediatrician | 35064454 | OH |
NPI | 1447216403 |
---|---|
Provider Name | Marvin E Miller |
First Address | Dayton, OH 45404-1815 |
Second Address | Dayton, OH 45404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 15/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0898551 | (05) | OH |
E64860 | (02) |