Healthcare Provider Details

I. General information

NPI: 1386887958
Provider Name (Legal Business Name): ERIN PAIGE MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2009
Last Update Date: 09/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 S.MAIN ST
NEWBERRY FL
32693-3239
US

IV. Provider business mailing address

911 S.MAIN ST
NEWBERRY FL
32693-3239
US

V. Phone/Fax

Practice location:
  • Phone: 352-463-2374
  • Fax: 352-463-2726
Mailing address:
  • Phone: 352-463-2374
  • Fax: 352-463-2726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME113793
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: