Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 14847 | NH |
N | 2080P0203X | Pediatric Critical Care Doctor | 223604 | NY |
NPI | 1134274731 |
---|---|
Provider Name | Michael Paul Miller |
First Address | Manchester, NH 03103-3502 |
Second Address | Manchester, NH 03103-3502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 20/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02784949 | (05) | NY |