Healthcare Provider Details

I. General information

NPI: 1063487999
Provider Name (Legal Business Name): AUDREY FRANCES MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HOSPITAL BLVD
ROSWELL GA
30076-4915
US

IV. Provider business mailing address

960 JOHNSON FERRY RD STE 400
ATLANTA GA
30342-4771
US

V. Phone/Fax

Practice location:
  • Phone: 770-793-5913
  • Fax:
Mailing address:
  • Phone: 404-257-0170
  • Fax: 404-591-3146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number042193
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD431754
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number238086-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number33386
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2008-00751
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number42362
License Number StateGA
# 7
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number042362
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: