MEDICARE: DR. GARY MILLER MD

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	207R00000X	Internal Medicine Physician	025717	CT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110233167	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	0442003	OTHER	UNITED H C
3	0V8223	OTHER	HEALTHNET
4	2469391	OTHER	AETNA
5	P44182552	OTHER	MULTIPLAN
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	01025717	OTHER	CIGNA
8	061606960	OTHER	PHCS
9	010025717CT01	OTHER	BCBS
10	061606960	OTHER	TRICARE
11	705992	OTHER	CT CARE
12	0407238	OTHER	EVERCARE
13	135723	OTHER	WELLCARE
14	HAP017	OTHER	OXFORD

General Provider Information

NPI Number	:	1528027430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY MILLER MD

Provider Business Mailing Address
First Line	:	100 N MOUNTAIN RD
Second Line	:
City	:	CANTON
State	:	CT
Zip	:	06019-2140
Country	:	US
Telephone Number	:	860-558-3662
Fax Number	:	860-693-0888

Provider Business Practice Location Address
First Line	:	100 N MOUNTAIN RD
Second Line	:
City	:	CANTON
State	:	CT
Zip	:	06019-2140
Country	:	US
Telephone Number	:	860-558-3662
Fax Number	:	860-693-0888

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

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	03/07/2023

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Directions to “ DR. GARY MILLER MD” Practice Location

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