Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS014378 | PA |
Y | 207Q00000X | Family Doctor | OS014378 | PA |
NPI | 1336387828 |
---|---|
Provider Name | Philip Attilio Miller |
First Address | Philipsburg, PA 16866-8257 |
Second Address | State College, PA 16803-2300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2009 |
Last Update Date | 15/09/2017 |