Healthcare Provider Details

I. General information

NPI: 1265921795
Provider Name (Legal Business Name): SAMUEL MORRISON MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK STREET YNHH GENERAL SURGERY
NEW HAVEN CT
06510-3220
US

IV. Provider business mailing address

20 YORK STREET YNHH - TOMPKINS 226
NEW HAVEN CT
06510-3220
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-4242
  • Fax:
Mailing address:
  • Phone: 203-688-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number1.083184
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: