MEDICARE: DR. LYNN M MILLER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	OS013649	PA
2	207T00000X	Neurological Surgery Physician	50690	MN

General Provider Information

NPI Number	:	1013084615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNN M MILLER DO

Provider Business Mailing Address
First Line	:	6 RED FOREST LN
Second Line	:
City	:	NORTH OAKS
State	:	MN
Zip	:	55127-6352
Country	:	US
Telephone Number	:	612-888-1433
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 RED FOREST LN
Second Line	:
City	:	NORTH OAKS
State	:	MN
Zip	:	55127-6352
Country	:	US
Telephone Number	:	612-888-1433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	04/18/2016

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