Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 42659 | CO |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 42659 | CO |
N | 207V00000X | Obstetrician & Gynecologist | 42659 | CO |
NPI | 1194802371 |
---|---|
Provider Name | Misha D Miller |
First Address | Denver, CO 80204-4507 |
Second Address | Denver, CO 80204-4507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 06/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I17487 | (02) | CO |