Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | D0035579 | MD |
NPI | 1093805301 |
---|---|
Provider Name | Susan J Miller |
First Address | Bethesda, MD 20814 |
Second Address | Bethesda, MD 20814-3107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2006 |
Last Update Date | 04/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E77475 | (02) | MD |