Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 1-100566 | AL |
Y | 207QA0505X | Family Doctor - Adult Medicine | 1-100566 | AL |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 1-100566 | AL |
NPI | 1124502331 |
---|---|
Provider Name | Wendy Paige Miller |
First Address | Gadsden, AL 35901-5301 |
Second Address | Gadsden, AL 35901-5301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2018 |
Last Update Date | 24/09/2018 |