Healthcare Provider Details

I. General information

NPI: 1679579551
Provider Name (Legal Business Name): KEVIN B MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7780 S BROADWAY STE 170
LITTLETON CO
80122-2633
US

IV. Provider business mailing address

PO BOX 713425
CHICAGO IL
60677-4325
US

V. Phone/Fax

Practice location:
  • Phone: 303-269-2920
  • Fax: 303-269-2921
Mailing address:
  • Phone: 800-953-0104
  • Fax: 303-765-6670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberDR.0036350
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: