Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 31949 | WI |
NPI | 1043328347 |
---|---|
Provider Name | Vincent T Miller |
First Address | Chippewa Falls, WI 54729-5867 |
Second Address | Chippewa Falls, WI 54729-5867 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2006 |
Last Update Date | 10/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31705500 | (05) | WI |
D14981 | (02) |