Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 14516 | OK |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 9752 | SD |
NPI | 1245265610 |
---|---|
Provider Name | Paul R Miller |
First Address | Rapid City, SD 57701-6003 |
Second Address | Rapid City, SD 57701-6003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 31/05/2016 |