Healthcare Provider Details

I. General information

NPI: 1922911486
Provider Name (Legal Business Name): AVI BIKO MILLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 BRIARWOOD INDUSTRIAL CT NE
BROOKHAVEN GA
30329-1608
US

IV. Provider business mailing address

3205 NW ELMWOOD DR
CORVALLIS OR
97330-1103
US

V. Phone/Fax

Practice location:
  • Phone: 770-693-8480
  • Fax:
Mailing address:
  • Phone: 541-231-1092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE042750
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: