Healthcare Provider Details

I. General information

NPI: 1184987828
Provider Name (Legal Business Name): MICHAL MILLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2012
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MERCY DR
COUNCIL BLUFFS IA
51503-3128
US

IV. Provider business mailing address

33 LEWIS RD 2ND FL
BINGHAMTON NY
13905
US

V. Phone/Fax

Practice location:
  • Phone: 855-524-4001
  • Fax: 712-325-2499
Mailing address:
  • Phone: 607-729-8156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME128125
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME128125
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number279103
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD-55151
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: