Healthcare Provider Details

I. General information

NPI: 1912116732
Provider Name (Legal Business Name): LAWRENCE MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E 9TH AVE STE 720S
DENVER CO
80220-3926
US

IV. Provider business mailing address

4500 E 9TH AVE SUITE #720S
DENVER CO
80220-3912
US

V. Phone/Fax

Practice location:
  • Phone: 303-355-3525
  • Fax:
Mailing address:
  • Phone: 303-355-3525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberDR.0054784
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: