Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0101260733 | VA |
N | 208600000X | Surgeon | 0101260733 | VA |
Y | 208200000X | Surgeon | MD437043 | PA |
Y | 208600000X | Surgeon | MD437043 | PA |
NPI | 1013122464 |
---|---|
Provider Name | Stephen E Miller |
First Address | Danville, PA 17822-4903 |
Second Address | Port Matilda, PA 16870-7153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 13/09/2021 |